340B Drug Pricing Program Database
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DSH450431G ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, DBA ST. DAVID'S MEDICAL CENTER (Active)
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Main Details
Name
ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, DBA ST. DAVID'S MEDICAL CENTER
Subdivision Name
CARDIOVASCULAR IMAGING CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450431G
Medicare Provider Number
450431
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/9/2016
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
St. David's Healthcare
David McKnight, CFO
(512) 544-5030
Primary Contact
St. David's Healthcare
JOSEPHINE FUENTES, 340B Program Coordinator
(512) 681-2136
Addresses
Street Address
3801 N. LAMAR BOULEVARD
SUITE 350
AUSTIN, TX 78756-4080
Billing Address
St David's Medical Center
919 E 32nd Street
Austin, TX 78705
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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