340B Drug Pricing Program Database
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DSH450021 BAYLOR UNIVERSITY MEDICAL CTR (Active)
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Main Details
Name
BAYLOR UNIVERSITY MEDICAL CTR
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450021
Medicare Provider Number
450021
Additional Details
Current Program Status
Active
Registration Date
1/6/2023
Participating Start Date
3/7/2023
Participating Approval Date
3/6/2023
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Baylor University Medical Center
Kyle Armstrong, President
(214) 820-3101
Primary Contact
Baylor University Medical Center
Dana Radman, Director of Pharmacy
(214) 820-2968
Addresses
Street Address
3500 GASTON AVENUE
DALLAS, TX 75246
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/01/2010; Terminated 4/1/2017; Reinstated 3/7/2023.
03/07/2023
June 2025
June 2025
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