Covered Entity Details

CAH451387-02 Uvalde Memorial Hospital (Active) - information as of 6/5/2025 2:40:39 PM

Main Details

Name

Uvalde Memorial Hospital

Subdivision Name

Primary Care Rural Health Clinic

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH451387-02

Medicare Provider Number

451387

Outpatient Facility Provider Number

673437

Additional Details

Current Program Status

Active

Registration Date

4/19/2017

Participating Start Date

7/1/2017

Participating Approval Date

4/25/2017

Last Recertification Date

9/2/2024

Contacts

Authorizing Official

Uvalde Memorial Hospital
Terri Contreras, Chief Financial Officer
(830) 278-6251 Ext: 1283

Primary Contact

Uvalde Memorial Hospital
ASHISH PUNALEKAR, PHARMACIST
(830) 278-6251 Ext: 1138

Addresses

Street Address

1025 Garner Field Road
Uvalde, TX 78801

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
CAH451387-01	Child	CAH	Uvalde Memorial Hospital	Sabinal Health Clinic	517 North Center Street	Sabinal	TX	Active
CAH451387-02	Child	CAH	Uvalde Memorial Hospital	Primary Care Rural Health Clinic	1025 Garner Field Road	Uvalde	TX	Active
CAH451387-03	Child	CAH	Uvalde Memorial Hospital	UMH HEMATOLOGY AND MEDICAL ONCOLOGY - Hematology and Oncology	1195 GARNER FIELD RD	UVALDE	TX	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	9/1/2023 5:36:43 PM	9/2/2024 11:30:05 AM	9/2/2024 11:30 AM
Details	Last Recertification Date	Update	Recertification	9/12/2022 3:14:41 PM	9/1/2023 5:36:43 PM	9/1/2023 5:36 PM
Details	Last Recertification Date	Update	Recertification	8/17/2021 9:11:44 AM	9/12/2022 3:14:41 PM	9/12/2022 3:14 PM
Contacts	Authorizing Official	Update	Change Request	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	Contreras, Terri Chief Financial Officer Uvalde Memorial Hospital 8302786251-1283	8/18/2022 7:00 AM
Contacts	Authorizing Official	Update	New Registration	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	10/4/2021 1:18 PM
Contacts	Signed By	Update	New Registration	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	10/4/2021 1:18 PM
Details	Last Recertification Date	Update	Recertification	9/2/2020 2:05:08 PM	8/17/2021 9:11:44 AM	8/17/2021 9:11 AM
Details	Last Recertification Date	Update	Recertification	8/21/2019 11:08:02 AM	9/2/2020 2:05:08 PM	9/2/2020 2:05 PM
Details	Last Recertification Date	Update	Recertification	8/16/2018 9:22:40 AM	8/21/2019 11:08:02 AM	8/21/2019 11:08 AM
Details	Last Recertification Date	Update	Recertification	11/20/2017 12:55:17 PM	8/16/2018 9:22:40 AM	8/16/2018 9:22 AM
Contacts	Primary Contact	Insert	Recertification		PUNALEKAR, ASHISH PHARMACIST Uvalde Memorial Hospital 8302786251-1138	11/20/2017 12:55 PM
Details	Last Recertification Date	Update	Recertification		11/20/2017 12:55:17 PM	11/20/2017 12:55 PM
Contacts	Authorizing Official	Update		Lopez, Valerie J. Chief Financial Officer 8302786251-1173	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	11/20/2017 12:23 PM
Contacts	Signed By	Update		Lopez, Valerie J. Chief Financial Officer 8302786251-1173	Lopez, Valerie J. Chief Financial Officer Uvalde 8302786251-1173	11/20/2017 12:23 PM
Contacts	Authorizing Official	Insert			Lopez, Valerie J. Chief Financial Officer 8302786251-1173	7/28/2017 1:04 PM
Contacts	Signed By	Insert			Lopez, Valerie J. Chief Financial Officer 8302786251-1173	7/28/2017 1:04 PM
Addresses	Main Address	Insert			1025 Garner Field Road Uvalde, TX 78801	4/25/2017 3:47 PM
Dates	Participating Approval Date	Update			4/25/2017 12:00:00 AM	4/25/2017 3:46 PM
Details	State	Update		Pending	Active	4/25/2017 3:46 PM
Dates	Start Date	Update			7/1/2017 12:00:00 AM	4/25/2017 3:46 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_77493	CAH451387-02	4/21/2017 12:48 PM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_77493	4/19/2017 4:43 PM
Details	Last Recertification Date	Insert				4/19/2017 4:43 PM
Details	Grant Number	Insert				4/19/2017 4:43 PM
Details	340B ID	Insert				4/19/2017 4:43 PM
Details	Is Authorizing Official EHB Data	Insert				4/19/2017 4:43 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/19/2017 4:43 PM
Details	Medicare Provider Number	Insert			451387	4/19/2017 4:43 PM
Details	Entity Name	Insert			Uvalde Memorial Hospital	4/19/2017 4:43 PM
Details	Program Code	Insert			CAH	4/19/2017 4:43 PM
Details	Entity Subname	Insert			Primary Care Rural Health Clinic	4/19/2017 4:43 PM
Dates	Participating Approval Date	Insert				4/19/2017 4:43 PM
Details	State	Insert			Pending	4/19/2017 4:43 PM
Dates	Registration Date	Insert			4/19/2017 12:00:00 AM	4/19/2017 4:43 PM
Dates	Signed By Date	Insert			4/19/2017 12:00:00 AM	4/19/2017 4:43 PM
Dates	Start Date	Insert				4/19/2017 4:43 PM
Terminations	Termination Comments	Insert				4/19/2017 4:43 PM
Terminations	Termination Date	Insert				4/19/2017 4:43 PM
Terminations	Termination Effective Date	Insert				4/19/2017 4:43 PM
Terminations	Termination Reason	Insert				4/19/2017 4:43 PM