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DSH450184E MEMORIAL HERMANN HOSPITAL SYSTEM (Terminated)
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Main Details
Name
MEMORIAL HERMANN HOSPITAL SYSTEM
Subdivision Name
The Woodlands - Outpatient Radiology-Therapeutic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450184E
Medicare Provider Number
450184
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/13/2011
Participating Start Date
1/1/2012
Participating Approval Date
12/19/2011
Last Recertification Date
8/25/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Memorial Hermann System
Rebecca Tucker, VP, Finance
(713) 456-5340
Primary Contact
DAVID STRICKLER, CHIEF FINANCIAL OFFICER
(713) 456-5340
Addresses
Street Address
9250 Pinecroft
The Woodlands, TX 77380
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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