340B Drug Pricing Program Database
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DSH450051 METHODIST DALLAS MEDICAL CENTER (Active)
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Main Details
Name
METHODIST DALLAS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450051
Medicare Provider Number
450051
Additional Details
Current Program Status
Active
Registration Date
7/1/2005
Participating Start Date
7/1/2005
Participating Approval Date
6/2/2005
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Methodist Health System
Jon T Albrecht, Corporate VP, Chief Pharmacy Officer
(214) 947-2504
Primary Contact
Methodist Dallas Medical Center
Ilka Ratsaphangthong, Director of Pharmacy
(214) 947-2481
Addresses
Street Address
1441 NORTH BECKLEY AVENUE
DALLAS, TX 75203
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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