340B Drug Pricing Program Database
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DSH450018MC UNIVERSITY OF TEXAS MEDICAL BRANCH (Approved)
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Main Details
Name
UNIVERSITY OF TEXAS MEDICAL BRANCH
Subdivision Name
UTMB CLEAR LAKE CAMPUS - VASCULAR LAB
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450018MC
Medicare Provider Number
450018
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/8/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/10/2025
Last Recertification Date
Contacts
Authorizing Official
UTMB
Carolanda B Woodgett, Senior Vice President and Chief Legal Officer
(409) 747-8735
Primary Contact
UTMB & CMC
Shari Doughty Gore, 340B Program Director UTMB & CMC
(870) 904-2219
Addresses
Street Address
200 BLOSSOM STREET
WEBSTER, TX 77598
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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