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OPTION CARE ENTERPRISES, INC.
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
OPTION CARE ENTERPRISES, INC.
Pharmacy Address
OPTION CARE
4708 W. SAHARA AVE.
LAS VEGAS, NV 89102-1630
Pharmacy Comments
Contract Details
Approval Date
2/13/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/13/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael Usgaard, Executive Director
(702) 960-5991
Contract Pharmacy Representative
Option Care
Derek Bilyk, Program Manager
(224) 813-1283
Signed By Date
1/12/2018
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