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DSH290007P UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA (Active)
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Main Details
Name
UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Subdivision Name
CLINIC: HIV WELLNESS CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH290007P
Medicare Provider Number
290007
Outpatient Facility Provider Number
290007
Additional Details
Current Program Status
Active
Registration Date
7/12/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/12/2013
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
University Medical Center of Southern Nevada
Mason Van Houweling, CEO
(702) 383-3862
Primary Contact
University Medical Center of Southern Nevada
Jamie King, Director, Pharmaceutical Services
(702) 383-3791
Addresses
Street Address
701 Shadow Lane
Suite 200
Las Vegas, NV 89106
Billing Address
University Medical Center of Southern Nevada
1800 W. Charleston Blvd.
Las Vegas, NV 89102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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