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DSH110069 HOUSTON MEDICAL CENTER (Active)
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Main Details
Name
HOUSTON MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110069
Medicare Provider Number
110069
Additional Details
Current Program Status
Active
Registration Date
6/15/2010
Participating Start Date
7/1/2010
Participating Approval Date
6/16/2010
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Houston Hospitals, Inc.
Sean Whilden, Vice-President/Chief Financial Officer
(478) 542-7959
Primary Contact
Houston Medical Center
Phillip Jennings Gilbert, Director of Pharmacy
(478) 322-4870
Addresses
Street Address
1601 WATSON BLVD
WARNER ROBINS, GA 31093
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/15/2010- DOC. RECD. TO CONFIRM ELIG. DSH PERCENTAGE;6/14/2010- ELIGIBLE FROM 4/1/2006 TO 6/30/2009, NOT ELIGIBLE FROM 7/1/2009 TO 6/30/2010.
06/16/2010
April 2025
April 2025
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