340B Drug Pricing Program Database
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DSH450184FQ MEMORIAL HERMANN HOSPITAL SYSTEM (Active)
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Main Details
Name
MEMORIAL HERMANN HOSPITAL SYSTEM
Subdivision Name
Greater Heights Convenient Care Center - Emergency Department
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450184FQ
Medicare Provider Number
450184
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/11/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/24/2019
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Memorial Hermann
Robert C Ogden, Associate Vice President of Finance
(713) 456-5111
Primary Contact
Memorial Hermann
Eric John Wucki, Director of Pharmacy-340B
(262) 527-2475
Addresses
Street Address
1431 Studemont Street
Houston, TX 77007
Billing Address
Memorial Hermann
929 Gessner Rd, Suite 2690
Houston, TX 77024
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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