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DSH030111 Banner – University Medical Center South (Active)
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Main Details
Name
Banner – University Medical Center South
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH030111
Medicare Provider Number
030111
Additional Details
Current Program Status
Active
Registration Date
3/31/2006
Participating Start Date
4/1/2006
Participating Approval Date
3/31/2006
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Banner Health
Meiko Onken, Chief Operating Officer
(602) 625-2651
Primary Contact
Banner University Medical Center Tucson
Kurt Weibel, Director of Pharmacy Services
(520) 694-6061
Addresses
Street Address
2800 EAST AJO WAY
TUCSON, AZ 85713
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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4/25/06 - CORRECTED START DATE TO 4/1/2006 (WAS INCORRECTLY SHOWN AS 12/1/1992), 4/24/06 - EDIT ADDRESS FROM 2700 TO 2800
04/25/2006
May 2025
May 2025
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