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CAH451364-00 OTTO KAISER MEMORIAL HOSPITAL (Active)
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Main Details
Name
OTTO KAISER MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH451364-00
Medicare Provider Number
451364
Additional Details
Current Program Status
Active
Registration Date
10/2/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/3/2023
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Karnes County Hospital District
David Lee, CEO
(830) 583-3401
Primary Contact
Hunter Pharmacy
Jesse Oviedo, Pharmacy Manager
(210) 912-4917
Addresses
Street Address
3349 S Hwy 181
KENEDY, TX 78119
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 4/1/2011, Termination Date 7/1/2016,Reinstatement 1/1/2024
10/02/2023
May 2025
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