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DSH450079 BAYLOR MEDICAL CENTER AT IRVING (Active)
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Main Details
Name
BAYLOR MEDICAL CENTER AT IRVING
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450079
Medicare Provider Number
450079
Additional Details
Current Program Status
Active
Registration Date
4/11/2019
Participating Start Date
7/1/2019
Participating Approval Date
6/13/2019
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Baylor Scott & White Medical Center - Irving
CINDY K. SCHAMP, PRESIDENT
(972) 990-8102
Primary Contact
BSWH
Gary Green, Pharmacy Director
(469) 939-5291
Addresses
Street Address
1901 NORTH MACARTHUR BLVD
IRVING, TX 75061
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2010, terminated 1/1/2019. Reinstated 7/1/2019.
06/13/2019
April 2025
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