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DSH450755C Methodist Hospital Levelland (DBA Covenant Hospital Levelland) (Active)
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Main Details
Name
Methodist Hospital Levelland (DBA Covenant Hospital Levelland)
Subdivision Name
LEVELLAND CLINIC NORTH RHC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450755C
Medicare Provider Number
450755
Outpatient Facility Provider Number
458815
Additional Details
Current Program Status
Active
Registration Date
6/17/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/20/2011
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Covenant Health
Cora Rivera, CFO
(806) 725-6547
Primary Contact
Covenant Health
Christine Farmer, Regional Executive Director of 340B Operations
(806) 725-6654
Addresses
Street Address
103 JOHN DUPREE DR.
LEVELLAND, TX 79336
Billing Address
COVENANT HOSPITAL LEVELLAND
1900 S. COLLEGE AVE
LEVELLAND, TX 79336
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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