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DM CLINICAL COLLABORATIONS
HM89178 Hemostasis and Thrombosis Center of Nevada
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Covered Entity Details
Entity Name
Hemostasis and Thrombosis Center of Nevada
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM89178
Entity Address
8352 W. Warm Springs Rd.
Suite 200
Las Vegas, NV 89113
Grant Number
H30MC24045
Participating Start Date
4/1/2018
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
DM CLINICAL COLLABORATIONS
Pharmacy Address
DBA INFUCARE RX
6108 SAN FERNANDO RD
GLENDALE, CA 91201-2240
Pharmacy Comments
Contract Details
Approval Date
4/3/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jerry Fox, CFO
(702) 960-5373
Contract Pharmacy Representative
Infucare
Mark Milburn, 340B Director
(877) 828-3940
Signed By Date
4/3/2024
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