Covered Entity Details

CAH451365-06 Ascension Seton d/b/a Ascension Seton Highland Lakes (Active) - information as of 5/27/2025 11:41:28 PM

Main Details

Name

Ascension Seton d/b/a Ascension Seton Highland Lakes

Subdivision Name

ASCENSION SETON - SHL RHC LAMPASAS

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH451365-06

Medicare Provider Number

451365

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/15/2020

Participating Start Date

1/1/2021

Participating Approval Date

10/23/2020

Last Recertification Date

8/23/2024

Contacts

Authorizing Official

Seton Healthcare Family
Karen Litterer, VP-COO SHL
(512) 715-3008

Primary Contact

Ascension Health
Rodrigo Rodriguez, 340B Program Director
(512) 324-9999 Ext: 77031

Addresses

Street Address

1205 CENTRAL TEXAS EXPY
LAMPASAS, TX 76550-3388

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
CAH451365-01	Child	CAH	SETON HIGHLAND LAKE	Seton Marble Falls Diagnostic Center	700 Hwy 281 N. Ste. D	Marble Falls	TX	Terminated
CAH451365-02	Child	CAH	SETON HIGHLAND LAKE	Seton Marble Falls Rehabilitation Center	700 Hwy 281 N	Marble Falls	TX	Terminated
CAH451365-03	Child	CAH	Ascension Seton d/b/a Ascension Seton Highland Lakes	Care-A-Van	3201 S WATER STREET	BURNET	TX	Active
CAH451365-04	Child	CAH	Ascension Seton d/b/a Ascension Seton Highland Lakes	ASCENSION SETON - SHL RHC KINGSLAND	525 RANCH ROAD 2900	KINGSLAND	TX	Active
CAH451365-05	Child	CAH	Ascension Seton d/b/a Ascension Seton Highland Lakes	ASCENSION SETON - SHL RHC BERTRAM HEALTHCARE	160 N LAMPASAS ST	BERTRAM	TX	Active
CAH451365-06	Child	CAH	Ascension Seton d/b/a Ascension Seton Highland Lakes	ASCENSION SETON - SHL RHC LAMPASAS	1205 CENTRAL TEXAS EXPY	LAMPASAS	TX	Active
CAH451365-08	Child	CAH	Ascension Seton d/b/a Ascension Seton Highland Lakes	ASCENSION SETON - ASHL - SHL RuralHealthClinic Burnet	200 JOHN W HOOVER PKWY	BURNET	TX	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Medicaid Billing	Medicaid: Number	Delete	Recertification	094151004 (TX)		8/23/2024 12:50 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	212790402 (TX)		8/23/2024 12:50 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1003833013 (TX)		8/23/2024 12:50 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1699947408 (TX)		8/23/2024 12:50 PM
Details	Last Recertification Date	Update	Recertification	8/22/2023 3:52:13 PM	8/23/2024 12:50:31 PM	8/23/2024 12:50 PM
Details	Last Recertification Date	Update	Recertification	8/25/2022 12:33:15 PM	8/22/2023 3:52:13 PM	8/22/2023 3:52 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	451365 (TX)		8/25/2022 12:33 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/25/2022 12:33 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		212790402	8/25/2022 12:33 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TX	8/25/2022 12:33 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1912304411 (TX)		8/25/2022 12:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1699947408	8/25/2022 12:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/25/2022 12:33 PM
Details	Last Recertification Date	Update	Recertification	8/17/2021 4:40:21 PM	8/25/2022 12:33:15 PM	8/25/2022 12:33 PM
Details	Last Recertification Date	Update	Recertification		8/17/2021 4:40:21 PM	8/17/2021 4:40 PM
Details	State	Update		Approved	Active	1/1/2021 12:01 AM
Contacts	Signed By	Insert	New Registration		Litterer, Karen VP-COO SHL Seton Healthcare Family 5127153008	10/23/2020 11:20 AM
Details	340B ID	Update	New Registration		CAH451365-06	10/23/2020 11:20 AM
Details	Entity Name	Update	New Registration	ASCENSION SETON HIGHLAND LAKES	Ascension Seton d/b/a Ascension Seton Highland Lakes	10/23/2020 11:20 AM
Details	Entity Subname	Update	New Registration	ASCENSION SETON	ASCENSION SETON - SHL RHC LAMPASAS	10/23/2020 11:20 AM
Dates	Participating Approval Date	Update	New Registration		10/23/2020 11:20:17 AM	10/23/2020 11:20 AM
Details	State	Update	New Registration	Pending	Approved	10/23/2020 11:20 AM
Dates	Signed By Date	Update	New Registration		10/15/2020 4:45:48 PM	10/23/2020 11:20 AM
Dates	Start Date	Update	New Registration		1/1/2021 12:00:00 AM	10/23/2020 11:20 AM
Addresses	Main Address	Insert	New Registration		1205 CENTRAL TEXAS EXPY LAMPASAS, TX 76550-3388	10/15/2020 12:17 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/15/2020 12:17 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		451365	10/15/2020 12:17 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		TX	10/15/2020 12:17 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/15/2020 12:17 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		094151004	10/15/2020 12:17 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		TX	10/15/2020 12:17 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1912304411	10/15/2020 12:17 AM
Medicaid Billing	NPI: State	Insert	New Registration		TX	10/15/2020 12:17 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1003833013	10/15/2020 12:17 AM
Medicaid Billing	NPI: State	Insert	New Registration		TX	10/15/2020 12:17 AM
Contacts	Primary Contact	Insert	New Registration		Rodriguez, Rodrigo 340B Program Director Ascension Health 5123249999-77031	10/15/2020 12:17 AM
Contacts	Authorizing Official	Insert	New Registration		Litterer, Karen VP-COO SHL Seton Healthcare Family 5127153008	10/15/2020 12:17 AM
Details	Assistance Received From Date	Insert	New Registration			10/15/2020 12:17 AM
Details	Assistance Received To Date	Insert	New Registration			10/15/2020 12:17 AM
Details	Last Recertification Date	Insert	New Registration			10/15/2020 12:17 AM
Details	Grant Number	Insert	New Registration			10/15/2020 12:17 AM
Details	340B ID	Insert	New Registration			10/15/2020 12:17 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/15/2020 12:17 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/15/2020 12:17 AM
Details	Medicare Provider Number	Insert	New Registration		451365	10/15/2020 12:17 AM
Details	Entity Name	Insert	New Registration		ASCENSION SETON HIGHLAND LAKES	10/15/2020 12:17 AM
Details	NOFO Number	Insert	New Registration			10/15/2020 12:17 AM
Details	Program Code	Insert	New Registration		CAH	10/15/2020 12:17 AM
Details	Entity Subname	Insert	New Registration		ASCENSION SETON	10/15/2020 12:17 AM
Dates	Participating Approval Date	Insert	New Registration			10/15/2020 12:17 AM
Details	State	Insert	New Registration		Pending	10/15/2020 12:17 AM
Dates	Registration Date	Insert	New Registration		10/15/2020 12:17:26 AM	10/15/2020 12:17 AM
Dates	Signed By Date	Insert	New Registration			10/15/2020 12:17 AM
Dates	Start Date	Insert	New Registration			10/15/2020 12:17 AM
Terminations	Termination Comments	Insert	New Registration			10/15/2020 12:17 AM
Terminations	Termination Date	Insert	New Registration			10/15/2020 12:17 AM
Terminations	Termination Effective Date	Insert	New Registration			10/15/2020 12:17 AM
Terminations	Termination Reason	Insert	New Registration			10/15/2020 12:17 AM