340B Drug Pricing Program Database
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PED453301-43 Driscoll Children's Hospital (Active)
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Main Details
Name
Driscoll Children's Hospital
Subdivision Name
CPSST Endocrinology - Brownsville - CPSST Endocrinology - Brownsville
Type
Children's Hospital
Rural
No
340B ID
PED453301-43
Medicare Provider Number
453301
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/1/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/3/2024
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Driscoll Children's Hospital
Steven Eric King, CFO
(361) 694-5934
Primary Contact
Driscoll Children's Hospital
Jessy Varkey Thomas, Director of Pharmacy
(361) 694-5061
Addresses
Street Address
5500 N Expressway 77
Brownsville, TX 78526
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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