Covered Entity Details

DSH450236A CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance (Active) - information as of 4/27/2025 11:32:20 PM

Main Details

Name

CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance

Subdivision Name

CHRISTUS Trinity Clinic - Orthopedics

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH450236A

Medicare Provider Number

450236

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/15/2019

Participating Start Date

4/1/2019

Participating Approval Date

1/25/2019

Last Recertification Date

8/16/2024

Contacts

Authorizing Official

CHRISTUS Health
Paul Harvey, CEO
(903) 439-4052

Primary Contact

Christus Mother Frances, Jacksonville
Joshua Ward, 340B Coordinator
(903) 606-7591

Addresses

Street Address

103B Medical Circle
Sulphur Springs, TX 75482-2138

Billing Address

CHRISTUS Mother Frances Hospital - Sulphur Springs - CHRISTUS Hopkins Health Alliance
115 Airport Road
Sulphur Springs, TX 75482

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	366812101,366812102	1033568621,1194174524

Shipping Addresses

Shipping Address 1

CHRISTUS Mother Frances Hospital - Sulphur Springs - CHRISTUS Hopkins Health Alliance
115 Airport Road
Sulphur Springs, TX 75482

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
DSH450236A	Child	DSH	CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	CHRISTUS Trinity Clinic - Orthopedics	103B Medical Circle	Sulphur Springs	TX	Active
DSH450236B	Child	DSH	CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	CHRISTUS TRINITY CLINIC - ENT	101 MEDICAL PLAZA	SULPHUR SPRINGS	TX	Active
DSH450236C	Child	DSH	CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	CHRISTUS TRINITY CLINIC - Pain Management	113 MEDICAL CIRCLE	SULPHUR SPRINGS	TX	Active
DSH450236D	Child	DSH	CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	CHRISTUS TRINITY CLINIC - General Surgery	113 AIRPORT RD	SULPHUR SPRINGS	TX	Terminated
DSH450236E	Child	DSH	CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	CHRISTUS TRINITY CLINIC - Physicians Plaza	111 MEDICAL CIRCLE	SULPHUR SPRINGS	TX	Active
DSH450236F	Child	DSH	CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	CHRISTUS TRINITY CLINIC - Primary Care North	105 MEDICAL PLZ	SULPHUR SPRINGS	TX	Active
DSH450236G	Child	DSH	CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	CHRISTUS TRINITY CLINIC - Urology	113 AIRPORT RD	SULPHUR SPRINGS	TX	Active
DSH450236H	Child	DSH	CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	CMFH GI CLINIC - Gastroenterology	107 MEDICAL CIR	SULPHUR SPRINGS	TX	Active
DSH450236J	Child	DSH	CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	CHRISTUS Trinity Clinic - Pulmonology	100 Medical Circle	Sulphur Springs	TX	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	9/6/2023 1:00:59 PM	8/16/2024 11:29:34 AM	8/16/2024 11:29 AM
Addresses	Billing Address	Update	Group Change Request	Christus Trinity Clinic 105 Medical Plaza Sulphur Springs, TX 75482	CHRISTUS Mother Frances Hospital - Sulphur Springs - CHRISTUS Hopkins Health Alliance 115 Airport Road Sulphur Springs, TX 75482	2/15/2024 6:57 AM
Addresses	Shipping Address	Delete	Group Change Request	Christus Trinity Clinic 105 Medical Plaza Sulphur Springs, TX 75482		2/15/2024 6:57 AM
Addresses	Shipping Address	Insert	Group Change Request		CHRISTUS Mother Frances Hospital - Sulphur Springs - CHRISTUS Hopkins Health Alliance 115 Airport Road Sulphur Springs, TX 75482	2/15/2024 6:57 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1285684225 (TX)		2/14/2024 4:46 PM
Details	Last Recertification Date	Update	Recertification	9/1/2022 1:48:40 PM	9/6/2023 1:00:59 PM	9/6/2023 1:00 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1184618548 (TX)		9/1/2022 1:48 PM
Details	Last Recertification Date	Update	Recertification	8/24/2021 4:11:18 PM	9/1/2022 1:48:40 PM	9/1/2022 1:48 PM
Dates	Last Date That 340B Drugs Purchased	Update	OPA Cancel Termination Request	1/27/2022 12:00:00 AM		3/17/2022 3:06 PM
Details	State	Update	OPA Cancel Termination Request	To Be Terminated	Active	3/17/2022 3:06 PM
Terminations	Termination Comments	Update	OPA Cancel Termination Request	Covered Entity has initiated outreach to the manufacturers and will work to reverse the applicable purchases.		3/17/2022 3:06 PM
Terminations	Termination Date	Update	OPA Cancel Termination Request	4/1/2022 12:00:00 AM		3/17/2022 3:06 PM
Terminations	Termination Effective Date	Update	OPA Cancel Termination Request	11/23/2021 12:00:00 AM		3/17/2022 3:06 PM
Terminations	Termination Reason	Update	OPA Cancel Termination Request	DSH percentage below statutory minimum		3/17/2022 3:06 PM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		1/27/2022 12:00:00 AM	2/9/2022 10:10 AM
Details	State	Update	Termination Request	Active	To Be Terminated	2/9/2022 10:10 AM
Terminations	Termination Comments	Update	Termination Request		Covered Entity has initiated outreach to the manufacturers and will work to reverse the applicable purchases.	2/9/2022 10:10 AM
Terminations	Termination Date	Update	Termination Request		4/1/2022 12:00:00 AM	2/9/2022 10:10 AM
Terminations	Termination Effective Date	Update	Termination Request		11/23/2021 12:00:00 AM	2/9/2022 10:10 AM
Terminations	Termination Reason	Update	Termination Request		DSH percentage below statutory minimum	2/9/2022 10:10 AM
Details	Last Recertification Date	Update	Recertification	9/9/2020 6:06:48 PM	8/24/2021 4:11:18 PM	8/24/2021 4:11 PM
Medicaid Billing	NPI: State	Update	Recertification		TX	9/9/2020 6:06 PM
Medicaid Billing	NPI: State	Update	Recertification		TX	9/9/2020 6:06 PM
Medicaid Billing	NPI: State	Update	Recertification		TX	9/9/2020 6:06 PM
Medicaid Billing	NPI: State	Update	Recertification		TX	9/9/2020 6:06 PM
Details	Last Recertification Date	Update	Recertification	8/26/2019 5:07:24 PM	9/9/2020 6:06:48 PM	9/9/2020 6:06 PM
Details	Last Recertification Date	Update	Recertification		8/26/2019 5:07:24 PM	8/26/2019 5:07 PM
Details	State	Update		Approved	Active	4/1/2019 12:05 AM
Addresses	Main Address	Update	Change Request	105 Medical Plaza Sulphur Springs, TX 75482-2138	103B Medical Circle Sulphur Springs, TX 75482-2138	2/1/2019 3:33 PM
Details	Entity Subname	Update	Change Request	CHRISTUS Trinity Clinic - Clinic	CHRISTUS Trinity Clinic - Orthopedics	2/1/2019 3:33 PM
Contacts	Signed By	Insert	New Registration		Harvey, Paul CEO CHRISTUS Health 9034394052	1/25/2019 11:17 AM
Details	340B ID	Update	New Registration		DSH450236A	1/25/2019 11:17 AM
Details	Entity Subname	Update	New Registration	CHRISTUS Trinity Clinic	CHRISTUS Trinity Clinic - Clinic	1/25/2019 11:17 AM
Dates	Participating Approval Date	Update	New Registration		1/25/2019 11:17:07 AM	1/25/2019 11:17 AM
Details	State	Update	New Registration	Pending	Approved	1/25/2019 11:17 AM
Dates	Signed By Date	Update	New Registration		1/18/2019 11:45:48 AM	1/25/2019 11:17 AM
Dates	Start Date	Update	New Registration		4/1/2019 12:00:00 AM	1/25/2019 11:17 AM
Addresses	Main Address	Insert	New Registration		105 Medical Plaza Sulphur Springs, TX 75482-2138	1/15/2019 2:17 PM
Addresses	Billing Address	Insert	New Registration		Christus Trinity Clinic 105 Medical Plaza Sulphur Springs, TX 75482	1/15/2019 2:17 PM
Addresses	Shipping Address	Insert	New Registration		Christus Trinity Clinic 105 Medical Plaza Sulphur Springs, TX 75482	1/15/2019 2:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/15/2019 2:17 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		366812101	1/15/2019 2:17 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		TX	1/15/2019 2:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/15/2019 2:17 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		366812102	1/15/2019 2:17 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		TX	1/15/2019 2:17 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1033568621	1/15/2019 2:17 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1194174524	1/15/2019 2:17 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1184618548	1/15/2019 2:17 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1285684225	1/15/2019 2:17 PM
Contacts	Authorizing Official	Insert	New Registration		Harvey, Paul CEO CHRISTUS Health 9034394052	1/15/2019 2:17 PM
Contacts	Primary Contact	Insert	New Registration		Ward, Joshua 340B Coordinator Christus Mother Frances, Jacksonville 9036067591	1/15/2019 2:17 PM
Details	Last Recertification Date	Insert	New Registration			1/15/2019 2:17 PM
Details	Grant Number	Insert	New Registration			1/15/2019 2:17 PM
Details	340B ID	Insert	New Registration			1/15/2019 2:17 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/15/2019 2:17 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/15/2019 2:17 PM
Details	Medicare Provider Number	Insert	New Registration		450236	1/15/2019 2:17 PM
Details	Entity Name	Insert	New Registration		CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance	1/15/2019 2:17 PM
Details	Program Code	Insert	New Registration		DSH	1/15/2019 2:17 PM
Details	Entity Subname	Insert	New Registration		CHRISTUS Trinity Clinic	1/15/2019 2:17 PM
Dates	Participating Approval Date	Insert	New Registration			1/15/2019 2:17 PM
Details	State	Insert	New Registration		Pending	1/15/2019 2:17 PM
Dates	Registration Date	Insert	New Registration		1/15/2019 2:17:38 PM	1/15/2019 2:17 PM
Dates	Signed By Date	Insert	New Registration			1/15/2019 2:17 PM
Dates	Start Date	Insert	New Registration			1/15/2019 2:17 PM
Terminations	Termination Comments	Insert	New Registration			1/15/2019 2:17 PM
Terminations	Termination Date	Insert	New Registration			1/15/2019 2:17 PM
Terminations	Termination Effective Date	Insert	New Registration			1/15/2019 2:17 PM
Terminations	Termination Reason	Insert	New Registration			1/15/2019 2:17 PM