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DSH450686F UNIVERSITY MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY MEDICAL CENTER
Subdivision Name
Medication Therapy Management Clinic - ACC - Medication Therapy Management Clinic - Medication Therapy Management
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450686F
Medicare Provider Number
450686
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/6/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/1/2023
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
120
Lubbock, TX 79415
Billing Address
University Medical Center Lubbock
602 Indiana Ave
Lubbock, TX 79415
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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