340B Drug Pricing Program Database
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DSH450024J UNIVERSITY MEDICAL CENTER OF EL PASO (Terminated)
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Main Details
Name
UNIVERSITY MEDICAL CENTER OF EL PASO
Subdivision Name
Delta Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450024J
Medicare Provider Number
450024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/14/2015
Last Recertification Date
8/22/2018
Termination Date
Termination Reason
1/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
University Medical Center of El Paso
MICHAEL NUNEZ, CFO
(915) 521-7626
Primary Contact
University Medical Center of El Paso
Myron Ray Lewis, Director of Pharmacy
(915) 521-7662
Addresses
Street Address
6314 Delta Drive
Room 186
El Paso, TX 79905
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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