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DSH450686P UNIVERSITY MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY MEDICAL CENTER
Subdivision Name
UMC HEALTH & WELLNESS HOSPITAL - HW Ambulatory Infusion - 6152
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450686P
Medicare Provider Number
450686
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/5/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/22/2024
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
University Medical Center
John Lowe, Vice President of Support Services
(806) 775-8516
Primary Contact
University Medical Center
Courtney Armstrong, Director of Pharmacy
(806) 775-9391
Addresses
Street Address
11011 SLIDE RD
LUBBOCK, TX 79424-2274
Billing Address
UNIVERSITY MEDICAL CENTER PHARMACY
602 Indiana Ave
Lubbock, TX 79415
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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