340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RALEY'S PHARMACY #123
DSH290019 CARSON TAHOE REGIONAL HEALTHCARE
Print
Covered Entity Details
Entity Name
CARSON TAHOE REGIONAL HEALTHCARE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH290019
Entity Address
1600 MEDICAL PARKWAY
CARSON CITY, NV 89703
Medicare Provider Number
290019
Participating Start Date
10/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
RALEY'S PHARMACY #123
Pharmacy Address
176 W. GOLDFIELD AVE.
YERINGTON, NV 89447
Pharmacy Comments
Contract Details
Approval Date
10/7/2022
Contract Begin Date
10/18/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Katie Kucera, Chief Financial Officer
(775) 445-8000 Ext: 5543
Contract Pharmacy Representative
Raley's
Cindy Fong, Director of Pharmacy
(916) 373-6411
Signed By Date
10/7/2022
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