340B Drug Pricing Program Database
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DSH290007AM UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA (Active)
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Main Details
Name
UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Subdivision Name
UMC WELLNESS CENTER - PRIMARY CARE: WELLNESS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH290007AM
Medicare Provider Number
290007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/1/2023
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 LN
STE 200
LAS VEGAS, NV 89106-4178
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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