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DSH290007W UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA (Active)
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Main Details
Name
UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Subdivision Name
PRIMARY CARE: NELLIS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH290007W
Medicare Provider Number
290007
Outpatient Facility Provider Number
290007
Additional Details
Current Program Status
Active
Registration Date
7/9/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
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
63 N Nellis Blvd.
Las Vegas, NV 89110
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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