340B Drug Pricing Program Database
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DSH440015AG UNIVERSITY OF TENNESSEE MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY OF TENNESSEE MEDICAL CENTER
Subdivision Name
University Cancer Specialists - Halls
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440015AG
Medicare Provider Number
440015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/10/2024
Participating Start Date
10/1/2024
Participating Approval Date
9/13/2024
Last Recertification Date
Contacts
Authorizing Official
University of Tennessee Medical Center
Kim C. Mason, Vice President, Pharmacy and Research
(865) 305-9124
Primary Contact
University of Tennessee Medical Center
Ivis Shane Trent, 340B Pharmacist
(865) 305-9166
Addresses
Street Address
7326 Maynardville Pike
STE 1400
Knoxville, TN 37938
Billing Address
University Health System, Inc.
Accts Payable
PO Box 32849
Knoxville, TN 37930
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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