340B Drug Pricing Program Database
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DSH450018CZ UNIVERSITY OF TEXAS MEDICAL BRANCH (Active)
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Main Details
Name
UNIVERSITY OF TEXAS MEDICAL BRANCH
Subdivision Name
UTMB HEALTH ANGLETON DANBURY CAMPUS - RAD ULTRASOUND
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450018CZ
Medicare Provider Number
450018
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/14/2015
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
UTMB
Carolanda B Woodgett, Senior Vice President and Chief Legal Officer
(409) 747-8735
Primary Contact
UTMB & CMC
Shari Doughty Gore, 340B Program Director UTMB & CMC
(870) 904-2219
Addresses
Street Address
132 EAST HOSPITAL DRIVE
ANGLETON, TX 77515
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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