340B Drug Pricing Program Database
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DSH450021E BAYLOR UNIVERSITY MEDICAL CTR (Active)
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Main Details
Name
BAYLOR UNIVERSITY MEDICAL CTR
Subdivision Name
Martha Foster Lung Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450021E
Medicare Provider Number
450021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/6/2023
Participating Start Date
3/7/2023
Participating Approval Date
3/7/2023
Last Recertification Date
8/16/2024
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
3410 Worth St.
Suite 250
Dallas, TX 75246
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2014; Terminated 4/1/2017; Reinstated 3/7/2023
03/07/2023
April 2025
April 2025
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