340B Drug Pricing Program Database
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DSH030064I Banner - University Medical Center Tucson (Active)
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Main Details
Name
Banner - University Medical Center Tucson
Subdivision Name
C/P-OG Hemeonc-Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030064I
Medicare Provider Number
030064
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
11/28/2007
Participating Start Date
1/1/2008
Participating Approval Date
11/28/2007
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
1891 W. ORANGE GROVE RD
Building 1
TUCSON, AZ 85704
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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1/11/12 Add New bill to address, Change AO and PC JH
11/28/2007
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