340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PED033302-78 PHOENIX CHILDREN'S HOSPITAL (Terminated)
Print
Main Details
Name
PHOENIX CHILDREN'S HOSPITAL
Subdivision Name
Phoenix Children's Heart Center - East Valley
Type
Children's Hospital
Rural
No
340B ID
PED033302-78
Medicare Provider Number
033302
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/10/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/13/2015
Last Recertification Date
9/6/2018
Termination Date
Termination Reason
10/1/2019
Never implemented the 340B Program
Contacts
Authorizing Official
Phoenix Children's Hospital
Kari Cornicelli, Executive Vice President and Chief Financial Officer
(602) 933-5468
Primary Contact
Phoenix Children's Hospital
Yolanda Douthard, Chief of Pharmacy Services
(602) 933-1891
Addresses
Street Address
3420 South Mercy Road
Suite 121
Gilbert, AZ 85297
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.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
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