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DSH450054AD SCOTT AND WHITE MEMORIAL HOSPITAL (Active)
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Main Details
Name
SCOTT AND WHITE MEMORIAL HOSPITAL
Subdivision Name
Baylor Scott & White Specialty Clinic - Harker Heights Morgan Street/Optometry
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450054AD
Medicare Provider Number
450054
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/16/2022
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Baylor Scott & White Medical Center - Temple
Gregory Haralson, President
(254) 724-6583
Primary Contact
Baylor Scott & White Medical Center - Temple
Christy Evans, Mgr Pharmacy
(254) 724-2081
Addresses
Street Address
326 MORGAN ST
HARKER HEIGHTS, TX 76548
Billing Address
SCOTT AND WHITE MEMORIAL HOSPITAL
2401 S 31ST ST
TEMPLE, TX 76508
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (4/1/2012) until terminated effective date: (10/01/2021), reinstatement effective date: (07/01/2022)
05/16/2022
April 2025
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