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PED453310-00 Ascension Seton d/b/a Dell Children's Medical Center of Central Texas (Active)
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Main Details
Name
Ascension Seton d/b/a Dell Children's Medical Center of Central Texas
Subdivision Name
Type
Children's Hospital
Rural
No
340B ID
PED453310-00
Medicare Provider Number
453310
Additional Details
Current Program Status
Active
Registration Date
6/15/2010
Participating Start Date
7/1/2010
Participating Approval Date
6/15/2010
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Dell Children's Medical Center
Debra Marie Brown, VP, Patient Care Services and COO
(512) 324-0186
Primary Contact
Ascension Health
Rodrigo Rodriguez, 340B Program Director
(512) 324-9999 Ext: 77031
Addresses
Street Address
4900 MUELLER BOULEVARD
AUSTIN, TX 78723
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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