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DSH320004 CHRISTUS Southern New Mexico (Active)
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Main Details
Name
CHRISTUS Southern New Mexico
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320004
Medicare Provider Number
320004
Additional Details
Current Program Status
Active
Registration Date
12/14/2010
Participating Start Date
4/1/2015
Participating Approval Date
12/14/2010
Last Recertification Date
9/10/2024
Contacts
Authorizing Official
Otero County Hospital Association
Bashar Naser, CFO
(575) 443-7848 Ext: 5754437841
Primary Contact
Otero County Hospital Associaton
Cheri Christine Moore, Financial Analyst
(575) 443-7841
Addresses
Street Address
2669 SCENIC DR
ALAMOGORDO, NM 88310-8734
Billing Address
CHRISTUS Southern New Mexico
2669 SCENIC DR
Alamogordo, NM 88310-8734
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/12/15 hospital participating under this 340B ID from 1/1/2011 thru 6/30/2012, hospital changed to SCH entity type effective 7/1/12, changed back to DSH effective 4/1/15 based on on-line registration submitted in January 2015.
04/28/2015
3/12/15 hospital participating under this 340B ID from 1/1/2011 thru 6/30/2012, hospital changed to SCH entity type effective 7/1/12, changed back to DSH effective 4/1/15 based on on-line registration submitted in January 2015, Govt certifying official is Pamela Heltner, County Manager, County of Otero, 575-439-2621, pheltner@co.otero.nm.us
03/12/2015
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