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CHC30721-01 Silver State Health Services (Terminated)
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Main Details
Name
Silver State Health Services
Subdivision Name
Silver State Health Services- Renaissance
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027672
340B ID
CHC30721-01
Grant Number
H80CS30721
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2020
Participating Start Date
7/22/2020
Participating Approval Date
7/22/2020
Last Recertification Date
3/6/2023
Termination Date
Termination Reason
4/1/2024
Failure to recertify
Contacts
Authorizing Official
Silver State Health Services
Mark Miyaoka, CEO
(702) 287-6575
Primary Contact
Silver State Health Services
Pauline Mah, COO
(702) 808-5739
Addresses
Street Address
2215 Renaissance Dr Ste C
Las Vegas, NV 89119-6729
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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