340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN ARIZONA DRUG CO.
DSH290007 UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Print
Covered Entity Details
Entity Name
UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH290007
Entity Address
1800 W Charleston Blvd.
LAS VEGAS, NV 89102
Medicare Provider Number
290007
Participating Start Date
7/1/1994
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WALGREEN ARIZONA DRUG CO.
Pharmacy Address
WALGREENS CENTRAL FILL #21372
120 N 83RD AVE
STE 200
TOLLESON, AZ 85353
Pharmacy Comments
Contract Details
Approval Date
10/13/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mason Van Houweling, CEO
(702) 383-3862
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session