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DSH450686B UNIVERSITY MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY MEDICAL CENTER
Subdivision Name
Ambulatory Care Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450686B
Medicare Provider Number
450686
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/9/2019
Participating Start Date
7/1/2019
Participating Approval Date
5/8/2019
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
University Medical Center
John Lowe, Vice President of Support Services
(806) 775-8516
Primary Contact
University Medical Center
Courtney Armstrong, Director of Pharmacy
(806) 775-9391
Addresses
Street Address
808 Joliet Avenue Suite 120
Lubbock, TX 79415
Billing Address
University Medical Center
602 Indiana Ave.
Lubbock, TX 79415
Comments
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