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PED453301-50 Driscoll Children's Hospital (Approved)
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Main Details
Name
Driscoll Children's Hospital
Subdivision Name
CPSST Diabetes McAllen - CPSST Diabetes McAllen
Type
Children's Hospital
Rural
No
340B ID
PED453301-50
Medicare Provider Number
453301
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/2/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/8/2025
Last Recertification Date
Contacts
Authorizing Official
Driscoll Children's Hospital
Steven Eric King, CFO
(361) 694-5934
Primary Contact
Driscoll Children's Hospital
Jessy Varkey Thomas, Director of Pharmacy
(361) 694-5061
Addresses
Street Address
1120 E. Ridge Rd
220
McAllen, TX 78503
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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