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DSH450054J SCOTT AND WHITE MEMORIAL HOSPITAL (Active)
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Main Details
Name
SCOTT AND WHITE MEMORIAL HOSPITAL
Subdivision Name
Baylor Scott & White Dialysis Center - Killeen
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450054J
Medicare Provider Number
450054
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
11/28/2007
Participating Start Date
1/1/2008
Participating Approval Date
11/28/2007
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Baylor Scott & White Medical Center - Temple
Gregory Haralson, President
(254) 724-6583
Primary Contact
Baylor Scott & White Medical Center - Temple
Christy Evans, Mgr Pharmacy
(254) 724-2081
Addresses
Street Address
3701 SCOTT AND WHITE DR
KILLEEN, TX 76543
Billing Address
SCOTT AND WHITE MEMORIAL HOSPITAL
2401 S 31st St
Temple, TX 76508
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/26/08-DOC RECD TO CONFIRM ELIG DSH ADJ %
11/28/2007
April 2025
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