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DSH450755D Methodist Hospital Levelland (dba Covenant Hospital Levelland) (Terminated)
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Main Details
Name
Methodist Hospital Levelland (dba Covenant Hospital Levelland)
Subdivision Name
SUNDOWN RHC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450755D
Medicare Provider Number
450755
Outpatient Facility Provider Number
458822
Additional Details
Current Program Status
Terminated
Registration Date
6/17/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/20/2011
Last Recertification Date
8/12/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Covenant Health Levelland
Bruce White, CEO
(806) 894-4963
Primary Contact
40755
MARTY COTTENOIR, RPH
(806) 894-4963 Ext: 1314
Addresses
Street Address
209E. RICHARDSON
SUNDOWN, TX 79372
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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