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SMITH MANAGEMENT CORP
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 MANAGEMENT CORP
Pharmacy Address
DBA SMITHS FOOD & DRUG #357
1255 BARING BLVD
SPARKS, NV 89431
Pharmacy Comments
Contract Details
Approval Date
3/13/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Dawn Ahner, EVP & Chief Administrative Officer
(775) 982-4404
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
1/15/2013
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