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CAH451376-00 LAVACA MEDICAL CENTER (Active)
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Main Details
Name
LAVACA MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH451376-00
Medicare Provider Number
451376
Additional Details
Current Program Status
Active
Registration Date
9/20/2010
Participating Start Date
9/30/2010
Participating Approval Date
9/30/2010
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Lavaca Medical Center
STEVE BOWEN, ADMINISTRATOR
(361) 798-3671 Ext: 1207
Primary Contact
Lavaca Medical Center
TRACY GREEN, CFO
(361) 798-3671 Ext: 1202
Addresses
Street Address
1400 N TEXANA
HALLETTSVILLE, TX 77964-2021
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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