340B Drug Pricing Program Database
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DSH440015C UNIVERSITY OF TENNESSEE MEDICAL CENTER (Terminated)
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Main Details
Name
UNIVERSITY OF TENNESSEE MEDICAL CENTER
Subdivision Name
University Cancer Specialists
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440015C
Medicare Provider Number
440015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2013
Participating Start Date
7/1/2013
Participating Approval Date
5/3/2013
Last Recertification Date
9/7/2023
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
University of Tennessee Medical Center
Kim C. Mason, Vice President, Pharmacy and Research
(865) 305-9124
Primary Contact
University of Tennessee Medical Center
Ivis Shane Trent, 340B Pharmacist
(865) 305-9166
Addresses
Street Address
270 Joule Street
Alcoa, TN 37701-2422
Billing Address
University of Tennessee Medical Center
Accounts Payable
PO Box 32849
Knoxville, TN 37930-2849
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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