340B Drug Pricing Program Database
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DSH030064AY Banner - University Medical Center Tucson (Active)
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Main Details
Name
Banner - University Medical Center Tucson
Subdivision Name
North Campus 2 BUMN - C/P-Endo-Clinic-NC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030064AY
Medicare Provider Number
030064
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/9/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/19/2020
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Banner Health
Meiko Onken, Chief Operating Officer
(602) 625-2651
Primary Contact
Banner University Medical Center Tucson
Kurt Weibel, Director of Pharmacy Services
(520) 694-6061
Addresses
Street Address
3838 N. Campbell Avenue
Building 2 Clinic G 3rd Floor
Tucson, AZ 85719
Billing Address
Banner Health Accounts Payable
PO Box 2977
Phoenix, AZ 85062
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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