Covered Entity Details

DSH450046BH CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE (Active) - information as of 4/25/2025 6:32:18 PM

Main Details

Name

CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE

Subdivision Name

CHRISTUS SURGICAL HOSPITAL - General Surgery

Type

Disproportionate Share Hospital

Rural

340B ID

DSH450046BH

Medicare Provider Number

450046

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/10/2024

Participating Start Date

4/1/2024

Participating Approval Date

2/16/2024

Last Recertification Date

9/6/2024

Contacts

Authorizing Official

CHRISTUS Spohn
Becky Rios, Interim CFO
(361) 881-3157

Primary Contact

CHRISTUS Spohn Region
Noreen Adame, Lead Pharmacy Buyer
(361) 902-4326

Addresses

Street Address

6130 PARKWAY DR
CORPUS CHRISTI, TX 78414-2455

Billing Address

CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE
600 Elizabeth St.
CORPUS CHRISTI, TX 78404

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
TX	1217754-03,1217754-01,2001414-01,1217754-05	1689641680

Shipping Addresses

Shipping Address 1

CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE
600 Elizabeth St.
CORPUS CHRISTI, TX 78404

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH450046AA	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Ultrasound	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046AB	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - O/P Chemotherapy	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046AC	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Radiation Therapy	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046AD	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Cardiopulmonary	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046AE	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Endoscopy/G.I.	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046AF	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Physical Therapy	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046AG	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Special Procedures	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046AH	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Pre-Testing	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046AJ	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Emergency Room	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AK	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Mother Baby Unit	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AL	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Surgery-General	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AM	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Day Surgery	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AN	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Recovery Room	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AP	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Lab - General 1	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AQ	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Mammography	5950 Saratoga Blvd	Corpus Christi	TX	Terminated
DSH450046AR	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Nuclear Medicin	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AS	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - MRI	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AT	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Cat Scanner	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AU	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Radiology Admin	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AV	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Cardiopulmonary	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AW	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Endoscopy/G.I.	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AX	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Phys Therapy	5950 Saratoga Blvd	Corpus Christi	TX	Active
DSH450046AY	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Cancer Center Calallen	14120 Northwest Blvd	Corpus Christi	TX	Terminated
DSH450046AZ	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Cancer Center Westside	1205 S. 19th St.	Corpus Christi	TX	Terminated
DSH450046BA	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Hector P. Garcia Center Quick Care Clinic - Clinic	2606 Hospital Blvd.	Corpus Christi	TX	Active
DSH450046BB	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Christus Spohn NeuroSciences Center - Neurosciences	1227 3rd St	Corpus Christi	TX	Terminated
DSH450046BC	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	CHRISTUS SURGICAL HOSPITAL - Anesthesiology	6130 PARKWAY DR	CORPUS CHRISTI	TX	Active
DSH450046BD	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Hector P. Garcia Center Quick Care Clinic - PM&R	2606 Hospital Blvd.	CORPUS CHRISTI	TX	Active
DSH450046BE	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	CHRISTUS SURGICAL HOSPITAL - Emergency Care	6130 PARKWAY DR	CORPUS CHRISTI	TX	Terminated
DSH450046BF	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	CHRISTUS SPOHN ORTHOPEDIC CLINIC - Clinic	613 ELIZABETH ST	CORPUS CHRISTI	TX	Active
DSH450046BG	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Hector P. Garcia Center Quick Care Clinic - Primary Care	2606 Hospital Blvd.	CORPUS CHRISTI	TX	Active
DSH450046BH	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	CHRISTUS SURGICAL HOSPITAL - General Surgery	6130 PARKWAY DR	CORPUS CHRISTI	TX	Active
DSH450046BJ	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	CHRISTUS SURGICAL HOSPITAL - Outpatient Center - General Surgery	6130 PARKWAY DR	CORPUS CHRISTI	TX	Active
DSH450046BK	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Medication Management - Clinic	5950 Saratoga Boulevard	Corpus Christi	TX	Active
DSH450046BL	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Hector P. Garcia Center Quick Care Clinic - Specialty Neurosurgery	2606 Hospital Blvd.	CORPUS CHRISTI	TX	Active
DSH450046BM	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	CHRISTUS Spohn Family Health Center - Westside - Specialty Dental	4617 Greenwood Drive	Corpus Christi	TX	Active
DSH450046BN	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Anesthesiology	5950 Saratoga Blvd	Corpus Christi	TX	ToBeTerminated
DSH450046BP	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Pre-Operative A	5950 Saratoga Blvd	Corpus Christi	TX	Approved
DSH450046BQ	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	South - Cardiology Non-Invasive	5950 Saratoga Blvd	Corpus Christi	TX	ToBeTerminated
DSH450046D	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	CHRISTUS SPOHN CANCER CENTER	1415 SANTA FE	CORPUS CHRISTI	TX	Active
DSH450046E	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI MEMORIAL	CHRISTUS Spohn Family Health Center - Northside	1406 Martin Luther King Drive	Corpus Christi	TX	Terminated
DSH450046F	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	CHRISTUS Spohn Family Health Center - Westside	4617 Greenwood Drive	Corpus Christi	TX	Active
DSH450046G	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI MEMORIAL	CHRISTUS Spohn Family Health Center - Padre Island	14202 S. Padre Island Drive	Corpus Christi	TX	Terminated
DSH450046H	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	CHRISTUS Spohn Family Health Center - Robstown	1038 Texas Yes Blvd	Robstown	TX	Active
DSH450046J	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Emergency Room	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046K	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Surgery-General	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046L	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Ambulatory Trea	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046M	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Recovery Room	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046N	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Lab - General 1	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046P	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Outpat Lab 1-#2	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046Q	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Cardiac Rehab	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046R	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Cardiac Cath	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046S	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Radiolo-Diagnos	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046T	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Day Surgery	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046U	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Nuclear Medicin	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046V	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - MRI	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046W	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Cat Scanner	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046X	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Cat Scanner - #2	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046Y	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Mammography	600 Elizabeth Street	Corpus Christi	TX	Terminated
DSH450046Z	Child	DSH	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	Shoreline - Hyper Oxyg Ther	600 Elizabeth Street	Corpus Christi	TX	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		9/6/2024 12:42:15 PM	9/6/2024 12:42 PM
Details	State	Update		Approved	Active	4/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Rios, Becky Interim CFO CHRISTUS Spohn 3618813157	2/16/2024 12:54 PM
Details	340B ID	Update	New Registration		DSH450046BH	2/16/2024 12:54 PM
Details	Entity Name	Update	New Registration	CHRISTUS SPOHN HOSP CORPUS CHRISTI	CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE	2/16/2024 12:54 PM
Details	Entity Subname	Update	New Registration	CHRISTUS SURGICAL HOSPITAL	CHRISTUS SURGICAL HOSPITAL - General Surgery	2/16/2024 12:54 PM
Dates	Participating Approval Date	Update	New Registration		2/16/2024 12:54:46 PM	2/16/2024 12:54 PM
Details	State	Update	New Registration	Pending	Approved	2/16/2024 12:54 PM
Dates	Signed By Date	Update	New Registration		2/15/2024 11:51:54 AM	2/16/2024 12:54 PM
Dates	Start Date	Update	New Registration		4/1/2024 12:00:00 AM	2/16/2024 12:54 PM
Addresses	Main Address	Insert	New Registration		6130 PARKWAY DR CORPUS CHRISTI, TX 78414-2455	1/10/2024 11:14 AM
Addresses	Billing Address	Insert	New Registration		CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE 600 Elizabeth St. CORPUS CHRISTI, TX 78404	1/10/2024 11:14 AM
Addresses	Shipping Address	Insert	New Registration		CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE 600 Elizabeth St. CORPUS CHRISTI, TX 78404	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1217754-03	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		TX	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1217754-01	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		TX	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		2001414-01	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		TX	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1217754-05	1/10/2024 11:14 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		TX	1/10/2024 11:14 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1689641680	1/10/2024 11:14 AM
Medicaid Billing	NPI: State	Insert	New Registration		TX	1/10/2024 11:14 AM
Contacts	Authorizing Official	Insert	New Registration		Rios, Becky Interim CFO CHRISTUS Spohn 3618813157	1/10/2024 11:14 AM
Contacts	Primary Contact	Insert	New Registration		Adame, Noreen Lead Pharmacy Buyer CHRISTUS Spohn Region 3619024326	1/10/2024 11:14 AM
Details	Assistance Received From Date	Insert	New Registration			1/10/2024 11:14 AM
Details	Assistance Received To Date	Insert	New Registration			1/10/2024 11:14 AM
Details	Last Recertification Date	Insert	New Registration			1/10/2024 11:14 AM
Details	Grant Number	Insert	New Registration			1/10/2024 11:14 AM
Details	340B ID	Insert	New Registration			1/10/2024 11:14 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/10/2024 11:14 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/10/2024 11:14 AM
Details	Medicare Provider Number	Insert	New Registration		450046	1/10/2024 11:14 AM
Details	Entity Name	Insert	New Registration		CHRISTUS SPOHN HOSP CORPUS CHRISTI	1/10/2024 11:14 AM
Details	NOFO Number	Insert	New Registration			1/10/2024 11:14 AM
Details	Program Code	Insert	New Registration		DSH	1/10/2024 11:14 AM
Details	Entity Subname	Insert	New Registration		CHRISTUS SURGICAL HOSPITAL	1/10/2024 11:14 AM
Dates	Participating Approval Date	Insert	New Registration			1/10/2024 11:14 AM
Details	State	Insert	New Registration		Pending	1/10/2024 11:14 AM
Dates	Registration Date	Insert	New Registration		1/10/2024 11:14:25 AM	1/10/2024 11:14 AM
Dates	Signed By Date	Insert	New Registration			1/10/2024 11:14 AM
Dates	Start Date	Insert	New Registration			1/10/2024 11:14 AM
Terminations	Termination Comments	Insert	New Registration			1/10/2024 11:14 AM
Terminations	Termination Date	Insert	New Registration			1/10/2024 11:14 AM
Terminations	Termination Effective Date	Insert	New Registration			1/10/2024 11:14 AM
Terminations	Termination Reason	Insert	New Registration			1/10/2024 11:14 AM