340B Drug Pricing Program Database
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DSH440015J UNIVERSITY OF TENNESSEE MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY OF TENNESSEE MEDICAL CENTER
Subdivision Name
UT Day Surgery
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440015J
Medicare Provider Number
440015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/4/2014
Last Recertification Date
9/4/2024
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
1934 Alcoa Hwy, STE 170
Knoxville, TN 37920
Billing Address
University Health System, Inc
Accts Payable
PO Box 32849
Knoxville, TN 37930
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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