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RED CHIP OF NEVADA
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
RED CHIP OF NEVADA
Pharmacy Address
18009 SKY PARK CIRCLE SUITE F
IRVINE, CA 92614-9261
Pharmacy Comments
Contract Details
Approval Date
10/9/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ann Beck, CFO Acute Care
(775) 982-6488
Contract Pharmacy Representative
Red Chip of Nevada
Mary Ann Barth, Co-Founder
(949) 223-9828
Signed By Date
10/9/2023
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