| Details | Last Recertification Date | Update | Recertification | 2/2/2024 9:50:28 AM | 2/18/2025 2:02:54 PM | 2/18/2025 2:02 PM |
| Contacts | Primary Contact | Update | Profile Change Request | Islam, Rizwana rizwanaislam@hhmhealth.org
Pharmacist
HHM Health
2142210855-1006 | Islam, Rizwana rizislam@hhmhealth.org
Pharmacist
HHM Health
2142210855-3059 | 2/22/2024 11:51 AM |
| Details | Last Recertification Date | Update | Recertification | 2/2/2023 5:00:09 PM | 2/2/2024 9:50:28 AM | 2/2/2024 9:50 AM |
| Contacts | Authorizing Official | Update | Profile Change Request | Hernandez, David
CFO
Healing Hands Ministries
2142210855-127 | Hernandez, David
CFO
Healing Hands Ministries, Inc.
2142210855-2003 | 10/10/2023 2:25 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | Change Request | | False | 2/16/2023 3:00 PM |
| Medicaid Billing | Medicaid: Number | Insert | Change Request | | 150597 | 2/16/2023 3:00 PM |
| Medicaid Billing | Medicaid: State | Insert | Change Request | | TX | 2/16/2023 3:00 PM |
| Medicaid Billing | NPI: Number | Insert | Change Request | | 1609584093 | 2/16/2023 3:00 PM |
| Medicaid Billing | NPI: State | Insert | Change Request | | TX | 2/16/2023 3:00 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | Recertification | | False | 2/2/2023 5:00 PM |
| Medicaid Billing | Medicaid: Number | Insert | Recertification | | 332302404 | 2/2/2023 5:00 PM |
| Medicaid Billing | Medicaid: State | Insert | Recertification | | TX | 2/2/2023 5:00 PM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1306287529 | 2/2/2023 5:00 PM |
| Medicaid Billing | NPI: State | Insert | Recertification | | TX | 2/2/2023 5:00 PM |
| Details | Last Recertification Date | Update | Recertification | 2/9/2022 9:31:30 AM | 2/2/2023 5:00:09 PM | 2/2/2023 5:00 PM |
| Contacts | Authorizing Official | Update | Change Request | Hawkins, Brian A
President and CEO
Healing Hands Ministries
2142210855-130 | Hernandez, David
CFO
Healing Hands Ministries
2142210855-127 | 1/26/2023 11:37 AM |
| Contacts | Primary Contact | Update | Change Request | Hernandez, David
CFO
Healing Hands Ministries
2142210855-127 | Islam, Rizwana rizwanaislam@hhmhealth.org
Pharmacist
HHM Health
2142210855-1006 | 1/26/2023 11:37 AM |
| Addresses | Shipping Address | Insert | Change Request | | Healing Hands Ministries DBA HHM Health Pharmacy
5750 Pineland Drive
344
Dallas, TX 75231 | 1/5/2023 5:57 PM |
| Details | Last Recertification Date | Update | Recertification | 2/18/2021 12:47:11 PM | 2/9/2022 9:31:30 AM | 2/9/2022 9:31 AM |
| Contacts | Authorizing Official | Update | AO Change Request | Wallace, Jason
COO
Healing Hands Ministries
2142210855-138 | Hawkins, Brian A
President and CEO
Healing Hands Ministries
2142210855-130 | 7/9/2021 6:50 AM |
| Medicaid Billing | Medicaid: Number | Delete | Recertification | 332302404 (TX) | | 2/18/2021 12:47 PM |
| Medicaid Billing | NPI: Number | Delete | Recertification | 1306287529 ( ) | | 2/18/2021 12:47 PM |
| Details | Last Recertification Date | Update | Recertification | 2/4/2020 2:49:56 PM | 2/18/2021 12:47:11 PM | 2/18/2021 12:47 PM |
| Contacts | Authorizing Official | Update | AO Change Request | Gardner, Janna
President, CEO
Healing Hands Ministries
2142210855-130 | Wallace, Jason
COO
Healing Hands Ministries
2142210855-138 | 2/11/2021 9:31 AM |
| Contacts | Authorizing Official | Update | Change Request | Gardner, brent
Director of Purchasing & Procurement
Healing Hands Ministries
2142210855-130 | Gardner, Janna
President, CEO
Healing Hands Ministries
2142210855-130 | 2/7/2020 5:18 PM |
| Contacts | Primary Contact | Update | Change Request | Gardner, Janna
President, CEO
Healing Hands Ministries
2142210855-130 | Hernandez, David
CFO
Healing Hands Ministries
2142210855-127 | 2/7/2020 5:18 PM |
| Details | Last Recertification Date | Update | Recertification | 2/22/2019 4:55:45 PM | 2/4/2020 2:49:56 PM | 2/4/2020 2:49 PM |
| Contacts | Authorizing Official | Update | Profile Change Request | Gardner, Janna
President, CEO
Healing Hands Ministries
2142210855-130 | Gardner, brent
Director of Purchasing & Procurement
Healing Hands Ministries
2142210855-130 | 2/4/2020 2:46 PM |
| Contacts | Signed By | Update | Profile Change Request | Gardner, Janna
President, CEO
Healing Hands Ministries
2142210855-130 | Gardner, brent
Director of Purchasing & Procurement
Healing Hands Ministries
2142210855-130 | 2/4/2020 2:46 PM |
| Contacts | Authorizing Official | Update | Profile Change Request | Gardner, Brent
Director of Procurement & Purchasing
Healing Hands Ministries
2143926265 | Gardner, Janna
President, CEO
Healing Hands Ministries
2142210855-130 | 2/4/2020 2:45 PM |
| Contacts | Signed By | Update | Profile Change Request | Gardner, Brent
Director of Procurement & Purchasing
Healing Hands Ministries
2143926265 | Gardner, Janna
President, CEO
Healing Hands Ministries
2142210855-130 | 2/4/2020 2:45 PM |
| Details | Last Recertification Date | Update | Recertification | | 2/22/2019 4:55:45 PM | 2/22/2019 4:55 PM |
| Details | State | Update | | Approved | Active | 4/1/2018 12:00 AM |
| Contacts | Signed By | Insert | New Registration | | Gardner, Brent
Director of Procurement & Purchasing
Healing Hands Ministries
2143926265 | 2/22/2018 1:20 PM |
| Details | 340B ID | Update | New Registration | | CHC30719-01 | 2/22/2018 1:20 PM |
| Dates | Participating Approval Date | Update | New Registration | | 2/22/2018 1:20:33 PM | 2/22/2018 1:20 PM |
| Details | State | Update | New Registration | Pending | Approved | 2/22/2018 1:20 PM |
| Dates | Signed By Date | Update | New Registration | | 2/21/2018 12:00:25 PM | 2/22/2018 1:20 PM |
| Dates | Start Date | Update | New Registration | | 4/1/2018 12:00:00 AM | 2/22/2018 1:20 PM |
| Addresses | Main Address | Insert | New Registration | |
5750 Pineland Drive, Suite 150
Dallas, TX 75231 | 2/20/2018 11:17 AM |
| Medicaid Billing | Medicaid: Is Primary | Insert | New Registration | | False | 2/20/2018 11:17 AM |
| Medicaid Billing | Medicaid: Number | Insert | New Registration | | 332302404 | 2/20/2018 11:17 AM |
| Medicaid Billing | Medicaid: State | Insert | New Registration | | TX | 2/20/2018 11:17 AM |
| Medicaid Billing | NPI: Number | Insert | New Registration | | 1306287529 | 2/20/2018 11:17 AM |
| Contacts | Primary Contact | Insert | New Registration | | Gardner, Janna
President, CEO
Healing Hands Ministries
2142210855-130 | 2/20/2018 11:17 AM |
| Contacts | Authorizing Official | Insert | New Registration | | Gardner, Brent
Director of Procurement & Purchasing
Healing Hands Ministries
2143926265 | 2/20/2018 11:17 AM |
| Details | Last Recertification Date | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Details | Grant Number | Insert | New Registration | | H80CS30719 | 2/20/2018 11:17 AM |
| Details | 340B ID | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Details | Medicare Provider Number | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Details | Entity Name | Insert | New Registration | | Healing Hands Ministries, Inc | 2/20/2018 11:17 AM |
| Details | Program Code | Insert | New Registration | | CH | 2/20/2018 11:17 AM |
| Details | Entity Subname | Insert | New Registration | | Healing Hands Ministries - Vickery Meadow | 2/20/2018 11:17 AM |
| Dates | Participating Approval Date | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Details | State | Insert | New Registration | | Pending | 2/20/2018 11:17 AM |
| Dates | Registration Date | Insert | New Registration | | 2/20/2018 11:17:38 AM | 2/20/2018 11:17 AM |
| Dates | Signed By Date | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Dates | Start Date | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Terminations | Termination Comments | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Terminations | Termination Date | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 2/20/2018 11:17 AM |
| Terminations | Termination Reason | Insert | New Registration | | | 2/20/2018 11:17 AM |