340B Drug Pricing Program Database
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DSH030064S Banner - University Medical Center Tucson (Terminated)
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Main Details
Name
Banner - University Medical Center Tucson
Subdivision Name
Banner - AZCC - Bone Marrow Transplant Adult
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030064S
Medicare Provider Number
030064
Outpatient Facility Provider Number
030064
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/20/2014
Last Recertification Date
9/4/2020
Termination Date
Termination Reason
10/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Banner University Medical Centers Tucson and South
Brad Hipp, Chief Financial Officer
(520) 694-3446
Primary Contact
Banner University Medical Center Tucson
Kurt Weibel, Director of Pharmacy Services
(520) 694-6061
Addresses
Street Address
3838 N. Campbell Avenue
Tucson, AZ 85719
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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