340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH450135 TEXAS HEALTH HARRIS METHODIST FORT WORTH (Terminated)
Print
Main Details
Name
TEXAS HEALTH HARRIS METHODIST FORT WORTH
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450135
Medicare Provider Number
450135
Additional Details
Current Program Status
Terminated
Registration Date
10/2/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/4/2015
Last Recertification Date
8/29/2018
Termination Date
Termination Reason
4/1/2019
DSH percentage below statutory minimum
Contacts
Authorizing Official
Texas Health Harris Methodist Fort Worth
Shelly Miland, VP Finance
(817) 250-3478
Primary Contact
Texas Health Fort Worth Hospital
Eric Bauer, Director of Pharmacy
(817) 250-2097
Addresses
Street Address
1301 PENNSYLVANIA AVENUE
FORT WORTH, TX 76104
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
11/4/15 Participated starting 9/9/2005, terminated 4/1/2015 through 12/31/15 due to The DSH percentage for the hospital fell below the qualifying threshold of 11.75% to 11.61%, reinstated based on new registration submitted in October 2015
11/04/2015
3/2/10 NAME CHANGE (WAS HARRIS METHODIST FORT WORTH)
03/02/2010
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