340B Drug Pricing Program Database
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PED453300-00 COOK CHILDREN'S MEDICAL CENTER (Active)
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Main Details
Name
COOK CHILDREN'S MEDICAL CENTER
Subdivision Name
Type
Children's Hospital
Rural
No
340B ID
PED453300-00
Medicare Provider Number
453300
Additional Details
Current Program Status
Active
Registration Date
2/25/2010
Participating Start Date
2/26/2010
Participating Approval Date
2/26/2010
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Cook Children's Medical Center
Nancy Cychol, EVP, Hospital Services
(682) 885-4340
Primary Contact
Cook Childrens Medical Center
Haydee Melanie Madrigal, Manager, 340B Program
(682) 303-1606
Addresses
Street Address
801 SEVENTH AVENUE
FORT WORTH, TX 76104-2733
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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