340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH450573 CHRISTUS JASPER MEMORIAL HOSPITAL (Terminated)
Print
Main Details
Name
CHRISTUS JASPER MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450573
Medicare Provider Number
450573
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2008
Participating Start Date
10/1/2004
Participating Approval Date
7/15/2008
Last Recertification Date
8/15/2024
Termination Date
Termination Reason
1/1/2025
Change of covered entity type
Contacts
Authorizing Official
CHRISTUS
Nikki Martin, Regional Director, Finance
(409) 899-7105
Primary Contact
Christus Jaspeer Memorial
Kirk Vital, Director Of Pharmacy
(409) 381-5616
Addresses
Street Address
1275 MARVIN HANCOCK DRIVE
JASPER, TX 75951
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
5/26/09- DOC RECD TO CONFIRM ELIG DSH ADJ %
06/15/2009
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session