340B Drug Pricing Program Database
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DSH030111A Banner – University Medical Center South (Active)
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Main Details
Name
Banner – University Medical Center South
Subdivision Name
Arizona Institute for Sports Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH030111A
Medicare Provider Number
030111
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/4/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/5/2023
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 E. Ajo Way, Suite 200
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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Participated starting 1/1/2012; Terminated 4/1/2022; Reinstated 4/1/2023.
01/04/2023
April 2025
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