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SMITH'S PHARMACY #378
DSH290001 RENOWN REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
RENOWN REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH290001
Entity Address
1155 MILL STREET
RENO, NV 89502-1474
Medicare Provider Number
290001
Participating Start Date
4/1/2009
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
SMITH'S PHARMACY #378
Pharmacy Address
750 SOUTH MEADOWS PARKWAY
RENO, NV 89521
Pharmacy Comments
Contract Details
Approval Date
7/30/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ann Beck, CFO Acute Care
(775) 982-6488
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
7/30/2021
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