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DSH450024D UNIVERSITY MEDICAL CENTER OF EL PASO (Active)
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Main Details
Name
UNIVERSITY MEDICAL CENTER OF EL PASO
Subdivision Name
University Medical Center Fabens
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450024D
Medicare Provider Number
450024
Outpatient Facility Provider Number
458619
Additional Details
Current Program Status
Active
Registration Date
5/3/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/25/2012
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
University Medical Center of El Paso
MICHAEL NUNEZ, CFO
(915) 521-7626
Primary Contact
UNIVERSITY MEDICAL CENTER OF EL PASO
DAVID CHAN, Asst Administrator Pharmacy Services
(915) 521-7662
Addresses
Street Address
101 Potasio ST
Fabens, TX 79838
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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