340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH450039AM TARRANT COUNTY HOSPITAL DISTRICT, JOHN PETER SMITH HOSPITAL (Terminated)
Print
Main Details
Name
TARRANT COUNTY HOSPITAL DISTRICT, JOHN PETER SMITH HOSPITAL
Subdivision Name
JPS SCHL-BSD HLTH CTR-CHAPEL HILL A
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450039AM
Medicare Provider Number
450039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2014
Participating Start Date
1/1/2015
Participating Approval Date
10/29/2014
Last Recertification Date
12/1/2017
Termination Date
Termination Reason
7/1/2018
Site closure
Contacts
Authorizing Official
JPS Health Network
Sharon R Clark, Senior Executive Vice President, CFO
(817) 702-6833
Primary Contact
Tarrant County Hospital District d/b/a/ JPS Health Network
Nicole Shoquist, Chief Pharmacy Officer
(806) 674-2644
Addresses
Street Address
4640 SYCAMORE SCHOOL ROAD
FORT WORTH, TX 76133-7356
Billing Address
Same as Street Address
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.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
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