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DSH450565 Palo Pinto General Hospital (Active)
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Main Details
Name
Palo Pinto General Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450565
Medicare Provider Number
450565
Additional Details
Current Program Status
Active
Registration Date
8/12/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/22/2011
Last Recertification Date
9/13/2024
Contacts
Authorizing Official
Palo Pinto General Hospital
Ross Korkmas, CEO
(940) 325-7891 Ext: 6400
Primary Contact
Palo Pinto General Hospital
Teri Cross, CPhT
(940) 328-6375
Addresses
Street Address
400 SW 25th Avenue
Mineral Wells, TX 76067-8246
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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