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DSH450229AS HENDRICK MEDICAL CENTER (Active)
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Main Details
Name
HENDRICK MEDICAL CENTER
Subdivision Name
Non-Invasive Cardiology - HRT - 12270
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450229AS
Medicare Provider Number
450229
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/3/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/19/2024
Last Recertification Date
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
1201 N 18th St
Abilene, TX 79601
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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