340B Drug Pricing Program Database
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DSH450039CM Tarrant County Hospital District d/b/a JPS Health Network (Terminated)
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Main Details
Name
Tarrant County Hospital District d/b/a JPS Health Network
Subdivision Name
Southeast Tarrant Medical Home Dental Clinic - Dental
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450039CM
Medicare Provider Number
450039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2019
Participating Start Date
1/1/2020
Participating Approval Date
12/9/2019
Last Recertification Date
9/1/2022
Termination Date
Termination Reason
7/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Tarrant County Hospital District d/b/a JPS Health Network
Joy Parker, SVP, Operations
(817) 702-5802 Ext: 8177027143
Primary Contact
Tarrant County Hospital District d/b/a/ JPS Health Network
Nicole Shoquist, Chief Pharmacy Officer
(806) 674-2644
Addresses
Street Address
1050 W Arkansas Lane
150
Arlington, TX 76013
Billing Address
JPS Health Network Central Fill Pharmacy
1500 S Main St
Fort Worth, TX 76104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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