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PED453301-00 Driscoll Children's Hospital (Active)
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Main Details
Name
Driscoll Children's Hospital
Subdivision Name
Type
Children's Hospital
Rural
No
340B ID
PED453301-00
Medicare Provider Number
453301
Additional Details
Current Program Status
Active
Registration Date
8/22/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/20/2011
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Driscoll Children's Hospital
Steven Eric King, CFO
(361) 694-5934
Primary Contact
Driscoll Children's Hospital
Jessy Varkey Thomas, Director of Pharmacy
(361) 694-5061
Addresses
Street Address
3533 South Alameda St
Corpus Christi, TX 78411
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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