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DSH450369A CHILDRESS REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
CHILDRESS REGIONAL MEDICAL CENTER
Subdivision Name
FOX RURAL HEALTH CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450369A
Medicare Provider Number
450369
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
12/6/2005
Participating Start Date
4/1/2016
Participating Approval Date
12/6/2005
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Childress Regional Medical Center
Emilee Stratton, CFO
(940) 937-9181
Primary Contact
Childress Regional Medical Center
Nick Patrick Barker, PHARMACIST
(940) 937-9129
Addresses
Street Address
1001 US HWY 83 NORTH
CHILDRESS, TX 79201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/15/16 Participated as DSH450369A starting 12/6/2005, Terminated 10/1/2015 through 3/31/2016 due to change of entity type to SCH, Participated as SCH450369-01 10/1/2015 to 3/31/2016, reinstated as DSH effective on 4/1/2016
03/15/2016
3/23/12 UPDATED MAIN ADD (WAS HIGHWAY 83 NORTH), ADDED NPI#
03/23/2012
May 2025
May 2025
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