340B Drug Pricing Program Database
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DSH030002 Banner – University Medical Center Phoenix (Active)
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Main Details
Name
Banner – University Medical Center Phoenix
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030002
Medicare Provider Number
030002
Additional Details
Current Program Status
Active
Registration Date
9/8/2005
Participating Start Date
9/9/2005
Participating Approval Date
9/9/2005
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Banner University Medical Center Phoenix
Cody W Ziemer, Chief Financial Officer
(602) 839-8507
Primary Contact
Banner University Medical Center Phoenix
Jeff Anderson, Director, Pharmacy Academic
(602) 839-2657
Addresses
Street Address
1111 EAST MCDOWELL ROAD
PHOENIX, AZ 85006
Billing Address
Banner Health Accounts Payable
PO Box 2977
Phoenix, AZ 85062
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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