340B Drug Pricing Program Database
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DSH030006G TUCSON MEDICAL CENTER (Terminated)
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Main Details
Name
TUCSON MEDICAL CENTER
Subdivision Name
Rincon Infusion Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030006G
Medicare Provider Number
030006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/6/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/12/2017
Last Recertification Date
8/31/2020
Termination Date
Termination Reason
10/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Tucson Medical Center
Maureen Coomler, Chief Operating Officer
(520) 324-4450
Primary Contact
Tucson Medical Center
Claudia Lorraine Koreny, Director of Pharmacy
(520) 324-2317
Addresses
Street Address
10350 E Drexel Road, Suite 160
Tucson, AZ 85747
Billing Address
Tucson Medical Center
5301 E Grant Road
Tucson, AZ 85712
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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