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DSH450229AR HENDRICK MEDICAL CENTER (Active)
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Main Details
Name
HENDRICK MEDICAL CENTER
Subdivision Name
Radiology-MRI-Hendrick Medical Plaza - 15430 - Radiology-MRI-HMP - 15430
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450229AR
Medicare Provider Number
450229
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2024
Participating Start Date
7/1/2024
Participating Approval Date
6/1/2024
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Hendrick Medical Center
Jeremy Walker, Chief Financial Officer
(325) 670-2207
Primary Contact
Hendrick Medical Center
Robert Joseph Wray, pharmacist
(325) 670-6405
Addresses
Street Address
5302 Buffalo Gap Rd
STE 102
Abilene, TX 79606
Billing Address
HENDRICK MEDICAL CENTER PHARMACY
1900 PINE STREET
PHARMACY ROOM 5407
ABILENE, TX 79601
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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