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CAH291309-00 BOULDER CITY HOSPITAL (Active)
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Main Details
Name
BOULDER CITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH291309-00
Medicare Provider Number
291309
Additional Details
Current Program Status
Active
Registration Date
7/20/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/7/2015
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Boulder City Hospital
Douglas B. Lewis, CFO
(702) 293-4111 Ext: 6509
Primary Contact
Boulder City Hospital
Roger Kent Waddington, Pharmacy Manager
(702) 293-4111 Ext: 1517
Addresses
Street Address
901 ADAMS BLVD
BOULDER CITY, NV 89005-2247
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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