340B Drug Pricing Program Database
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DSH450018FC UNIVERSITY OF TEXAS MEDICAL BRANCH (Active)
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Main Details
Name
UNIVERSITY OF TEXAS MEDICAL BRANCH
Subdivision Name
UTMB HEALTH ANGLETON DANBURY CAMPUS LABORATORY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450018FC
Medicare Provider Number
450018
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/6/2020
Participating Start Date
7/1/2020
Participating Approval Date
5/27/2020
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
UTMB
Carolanda B Woodgett, Senior Vice President and Chief Legal Officer
(409) 747-8735
Primary Contact
UTMB & CMC
Shari Doughty Gore, 340B Program Director UTMB & CMC
(870) 904-2219
Addresses
Street Address
132 EAST HOSPITAL DRIVE
ANGLETON, TX 77515
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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