Covered Entity Details

SCH450370-01 COLUMBUS COMMUNITY HOSPITAL (Active) - information as of 5/13/2025 1:36:05 AM

Main Details

Name

COLUMBUS COMMUNITY HOSPITAL

Subdivision Name

Columbus Medical Clinic

Type

Sole Community Hospital

Rural

340B ID

SCH450370-01

Medicare Provider Number

450370

Outpatient Facility Provider Number

458608

Additional Details

Current Program Status

Active

Registration Date

10/27/2014

Participating Start Date

1/1/2015

Participating Approval Date

11/6/2014

Last Recertification Date

8/15/2024

Contacts

Authorizing Official

Columbus Community Hospital
James Vanek, CEO
(979) 493-7561

Primary Contact

Columbus Community Hospital
Greg Pritchett, CFO
(979) 493-7562

Addresses

Street Address

2122 Hwy 71 s
Columbus, TX 78934

Billing Address
Same as Street Address

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?
No

Shipping Addresses

Same as Street Address

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
SCH450370-01	Child	SCH	COLUMBUS COMMUNITY HOSPITAL	Columbus Medical Clinic	2122 Hwy 71 s	Columbus	TX	Active
SCH450370-02	Child	SCH	COLUMBUS COMMUNITY HOSPITAL	Four Oaks Medical Clinic	109 Shult Dr	Columbus	TX	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/16/2023 9:27:34 AM	8/15/2024 2:30:15 PM	8/15/2024 2:30 PM
Details	Last Recertification Date	Update	Recertification	8/29/2022 4:13:39 PM	8/16/2023 9:27:34 AM	8/16/2023 9:27 AM
Details	Last Recertification Date	Update	Recertification	9/7/2021 4:24:18 PM	8/29/2022 4:13:39 PM	8/29/2022 4:13 PM
Contacts	Primary Contact	Update	Group Change Request	Bardin, Nelda Administrative Assistant Columbus Community Hospital 9797322371-6570	Pritchett, Greg CFO Columbus Community Hospital 9794937562	9/10/2021 1:28 PM
Details	Last Recertification Date	Update	Recertification	8/17/2020 12:11:27 PM	9/7/2021 4:24:18 PM	9/7/2021 4:24 PM
Details	Last Recertification Date	Update	Recertification	8/26/2019 10:06:19 AM	8/17/2020 12:11:27 PM	8/17/2020 12:11 PM
Details	Last Recertification Date	Update	Recertification	8/16/2018 12:38:55 PM	8/26/2019 10:06:19 AM	8/26/2019 10:06 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	112272302 (TX)		4/23/2019 2:58 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1558474999 ( )		4/23/2019 2:58 PM
Details	Last Recertification Date	Update	Recertification	11/8/2017 11:43:07 AM	8/16/2018 12:38:55 PM	8/16/2018 12:38 PM
Contacts	Primary Contact	Insert	Recertification		Bardin, Nelda Administrative Assistant Columbus Community Hospital 9797322371-6570	11/8/2017 11:43 AM
Details	Last Recertification Date	Update	Recertification	8/17/2016 12:00:00 AM	11/8/2017 11:43:07 AM	11/8/2017 11:43 AM
Contacts	Authorizing Official	Update		Vanek, James CEO 9794937561	Vanek, James CEO Columbus Community Hospital 9794937561	10/6/2017 4:12 PM
Contacts	Authorizing Official	Insert			Vanek, James CEO 9794937561	8/9/2017 4:56 PM
Addresses	Main Address	Insert			2122 Hwy 71 s Columbus, TX 78934	8/31/2016 8:56 AM
Contacts	Signed By	Insert			Thomas, Rob CEO 9794937561	8/31/2016 8:56 AM
Medicaid Billing	NPI: Number	Update		1932158367	1558474999	8/17/2016 3:38 PM
Details	Last Recertification Date	Update		9/9/2015 12:00:00 AM	8/17/2016 12:00:00 AM	8/17/2016 3:38 PM
Details	Last Recertification Date	Update			9/9/2015 12:00:00 AM	9/9/2015 9:41 AM
Dates	Participating Approval Date	Update			11/6/2014 12:00:00 AM	11/6/2014 10:34 PM
Details	State	Update		Pending	Active	11/6/2014 10:34 PM
Dates	Start Date	Update			1/1/2015 12:00:00 AM	11/6/2014 10:34 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_47737	SCH450370-01	10/29/2014 8:25 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_47737	10/27/2014 1:21 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	10/27/2014 1:21 PM
Medicaid Billing	Medicaid: Number	Insert			112272302	10/27/2014 1:21 PM
Medicaid Billing	Medicaid: State	Insert			TX	10/27/2014 1:21 PM
Medicaid Billing	NPI: Number	Insert			1932158367	10/27/2014 1:21 PM
Details	Last Recertification Date	Insert				10/27/2014 1:21 PM
Details	Grant Number	Insert				10/27/2014 1:21 PM
Details	340B ID	Insert				10/27/2014 1:21 PM
Details	Is Authorizing Official EHB Data	Insert				10/27/2014 1:21 PM
Dates	Last Date That 340B Drugs Purchased	Insert				10/27/2014 1:21 PM
Details	Medicare Provider Number	Insert			450370	10/27/2014 1:21 PM
Details	Entity Name	Insert			COLUMBUS COMMUNITY HOSPITAL	10/27/2014 1:21 PM
Details	Program Code	Insert			SCH	10/27/2014 1:21 PM
Details	Entity Subname	Insert			Columbus Medical Clinic	10/27/2014 1:21 PM
Dates	Participating Approval Date	Insert				10/27/2014 1:21 PM
Details	State	Insert			Pending	10/27/2014 1:21 PM
Dates	Registration Date	Insert			10/27/2014 12:00:00 AM	10/27/2014 1:21 PM
Dates	Signed By Date	Insert			10/27/2014 12:00:00 AM	10/27/2014 1:21 PM
Dates	Start Date	Insert				10/27/2014 1:21 PM
Terminations	Termination Comments	Insert				10/27/2014 1:21 PM
Terminations	Termination Date	Insert				10/27/2014 1:21 PM
Terminations	Termination Effective Date	Insert				10/27/2014 1:21 PM
Terminations	Termination Reason	Insert				10/27/2014 1:21 PM