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DSH450213NZ UNIVERSITY HEALTH SYSTEM (ToBeTerminated)
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Main Details
Name
UNIVERSITY HEALTH SYSTEM
Subdivision Name
Pavilion Lab
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450213NZ
Medicare Provider Number
450213
Outpatient Facility Provider Number
Additional Details
Current Program Status
ToBeTerminated
Registration Date
4/3/2024
Participating Start Date
7/1/2024
Participating Approval Date
6/4/2024
Last Recertification Date
8/26/2024
Termination Date
Termination Reason
7/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
University Health
Christopher Reed Hurley, CFO
(210) 415-5321
Primary Contact
University Health System
Christopher Randal Schexnayder, Executive Director of Support Services
(504) 908-2188
Addresses
Street Address
4647 Medical Dr
San Antonio, TX 78229
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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