340B Drug Pricing Program Database
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DSH290007AF UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA (Active)
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Main Details
Name
UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Subdivision Name
CLINIC:PEDIATRICS OUTPATIENT
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH290007AF
Medicare Provider Number
290007
Outpatient Facility Provider Number
290007
Additional Details
Current Program Status
Active
Registration Date
4/4/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/19/2018
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
800 Hope Place, 3rd floor
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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