340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PED453300-21 COOK CHILDREN'S MEDICAL CENTER (Active)
Print
Main Details
Name
COOK CHILDREN'S MEDICAL CENTER
Subdivision Name
Dodson Specialty Clinic ~ Rheumatology
Type
Children's Hospital
Rural
No
340B ID
PED453300-21
Medicare Provider Number
453300
Outpatient Facility Provider Number
453300
Additional Details
Current Program Status
Active
Registration Date
11/22/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/12/2013
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Cook Children's Medical Center
Nancy Cychol, EVP, Hospital Services
(682) 885-4340
Primary Contact
Cook Childrens Medical Center
Haydee Melanie Madrigal, Manager, 340B Program
(682) 303-1606
Addresses
Street Address
1500 Cooper St
Fort Worth, TX 76104
Billing Address
Cook Children's Medical Center
801 7th Avenue
Fort Worth, TX 76104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session