No
McCulloch County Hospital District dba Heart of Texas Healthcare System
2008 Nine Road
Brady, TX 76825-7682
| CAH451348-01 | Child | CAH | MCCULLOCH COUNTY HOSPITAL DISTRICT D/B/A HEART OF TEXAS HEALTHCARE SYSTEM | BRADY MEDICAL CLINIC | 2010 NINE ROAD | BRADY | TX | Active |
| Addresses | Shipping Address | Insert | Group Change Request | | McCulloch County Hospital District dba Heart of Texas Healthcare System
2008 Nine Road
Brady, TX 76825-7682 | 12/9/2024 12:37 PM |
| Details | Last Recertification Date | Update | Recertification | 8/15/2023 12:44:20 PM | 8/15/2024 2:53:55 PM | 8/15/2024 2:53 PM |
| Details | Last Recertification Date | Update | Recertification | 8/29/2022 2:38:16 PM | 8/15/2023 12:44:20 PM | 8/15/2023 12:44 PM |
| Details | Last Recertification Date | Update | Recertification | 8/16/2021 3:05:10 PM | 8/29/2022 2:38:16 PM | 8/29/2022 2:38 PM |
| Contacts | Primary Contact | Update | Group Change Request | Clark, Sabrina
Pharmacy Supervisor
Heart of Texas Healthcare System
3257923522 | Fuller, John K.
RPH
PharmaCare Services
2107454015 | 10/14/2021 1:07 PM |
| Details | Last Recertification Date | Update | Recertification | 8/24/2020 3:05:30 PM | 8/16/2021 3:05:10 PM | 8/16/2021 3:05 PM |
| Details | Last Recertification Date | Update | Recertification | 8/21/2019 11:06:32 AM | 8/24/2020 3:05:30 PM | 8/24/2020 3:05 PM |
| Details | Last Recertification Date | Update | Recertification | 8/15/2018 9:56:28 AM | 8/21/2019 11:06:32 AM | 8/21/2019 11:06 AM |
| Contacts | Primary Contact | Update | Change Request | Shunk, Tina Leigh
Pharmacy Manager
Heart of Texas Healthcare System
3257923946 | Clark, Sabrina
Pharmacy Supervisor
Heart of Texas Healthcare System
3257923522 | 6/4/2019 9:45 AM |
| Details | Last Recertification Date | Update | Recertification | 11/3/2017 10:29:43 AM | 8/15/2018 9:56:28 AM | 8/15/2018 9:56 AM |
| Details | Entity Name | Update | Change Request | MCCULLOCH COUNTY HOSPITAL DISTRICT D/B/A HEART OF TEXAS MEMORIAL HOSPITAL | MCCULLOCH COUNTY HOSPITAL DISTRICT D/B/A HEART OF TEXAS HEALTHCARE SYSTEM | 3/30/2018 9:53 AM |
| Addresses | Billing Address | Update | Change Request | MCCULLOCH COUNTY HOSPITAL DISTRICT D/B/A HEART OF TEXAS MEMORIAL HOSPITAL
P.O BOX 1150
BRADY, TX 76825 | MCCULLOCH COUNTY HOSPITAL DISTRICT D/B/A HEART OF TEXAS HEALTHCARE SYSTEM
P.O BOX 1150
BRADY, TX 76825 | 3/28/2018 12:32 PM |
| Contacts | Primary Contact | Update | Recertification | BUCY, TINA
DIRECTOR
3255972114 | Shunk, Tina Leigh
Pharmacy Manager
Heart of Texas Healthcare System
3257923946 | 11/3/2017 10:29 AM |
| Details | Last Recertification Date | Update | Recertification | 9/1/2016 12:00:00 AM | 11/3/2017 10:29:43 AM | 11/3/2017 10:29 AM |
| Contacts | Authorizing Official | Update | AO Change Request | WATSON, ED
CFO
3257923943 | Jones, Tim
CEO
Heart of Texas Healthcare System
3255972901-3940 | 10/18/2017 9:10 AM |
| Addresses | Main Address | Insert | | |
2010 NINE ROAD
BRADY, TX 76825 | 9/1/2016 12:27 PM |
| Contacts | Authorizing Official | Insert | | | WATSON, ED
CFO
3257923943 | 9/1/2016 12:27 PM |
| Contacts | Primary Contact | Insert | | | BUCY, TINA
DIRECTOR
3255972114 | 9/1/2016 12:27 PM |
| Details | Last Recertification Date | Update | | 8/31/2015 12:00:00 AM | 9/1/2016 12:00:00 AM | 9/1/2016 12:27 PM |
| Details | Last Recertification Date | Update | | 8/6/2014 12:00:00 AM | 8/31/2015 12:00:00 AM | 8/31/2015 11:18 AM |
| Details | Last Recertification Date | Update | | 9/5/2013 5:32:01 PM | 8/6/2014 12:00:00 AM | 8/6/2014 5:16 PM |
| Details | Last Recertification Date | Update | | 7/1/2012 12:00:00 AM | 9/5/2013 5:32:01 PM | 9/5/2013 5:32 PM |
| Details | Last Recertification Date | Update | | | 7/1/2012 12:00:00 AM | 6/1/2012 9:57 AM |
| Addresses | Billing Address | Insert | | | MCCULLOCH COUNTY HOSPITAL DISTRICT D/B/A HEART OF TEXAS MEMORIAL HOSPITAL
P.O BOX 1150
BRADY, TX 76825 | 9/14/2010 3:10 PM |
| Details | Last Recertification Date | Insert | | | | 9/14/2010 3:10 PM |
| Details | Grant Number | Insert | | | | 9/14/2010 3:10 PM |
| Details | 340B ID | Insert | | | CAH451348-01 | 9/14/2010 3:10 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 9/14/2010 3:10 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 9/14/2010 3:10 PM |
| Details | Medicare Provider Number | Insert | | | 451348 | 9/14/2010 3:10 PM |
| Details | Entity Name | Insert | | | MCCULLOCH COUNTY HOSPITAL DISTRICT D/B/A HEART OF TEXAS MEMORIAL HOSPITAL | 9/14/2010 3:10 PM |
| Details | Program Code | Insert | | | CAH | 9/14/2010 3:10 PM |
| Details | Entity Subname | Insert | | | BRADY MEDICAL CLINIC | 9/14/2010 3:10 PM |
| Dates | Participating Approval Date | Insert | | | 9/2/2010 12:00:00 AM | 9/14/2010 3:10 PM |
| Details | State | Insert | | | Active | 9/14/2010 3:10 PM |
| Dates | Registration Date | Insert | | | 9/2/2010 12:00:00 AM | 9/14/2010 3:10 PM |
| Dates | Signed By Date | Insert | | | 8/24/2010 12:00:00 AM | 9/14/2010 3:10 PM |
| Dates | Start Date | Insert | | | 9/2/2010 12:00:00 AM | 9/14/2010 3:10 PM |
| Terminations | Termination Comments | Insert | | | | 9/14/2010 3:10 PM |
| Terminations | Termination Date | Insert | | | | 9/14/2010 3:10 PM |
| Terminations | Termination Effective Date | Insert | | | | 9/14/2010 3:10 PM |
| Terminations | Termination Reason | Insert | | | | 9/14/2010 3:10 PM |