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SCH450090-00 NORTH TEXAS MEDICAL CENTER (Terminated)
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Main Details
Name
NORTH TEXAS MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH450090-00
Medicare Provider Number
450090
Additional Details
Current Program Status
Terminated
Registration Date
1/17/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/25/2023
Last Recertification Date
Termination Date
Termination Reason
10/1/2023
DSH percentage below statutory minimum
Contacts
Authorizing Official
North Texas Medical Center
Thomas Sledge, Chief Executive Officer
(940) 612-8616
Primary Contact
North Texas Medical Center
Christy Daughtry, Program Coordinator
(940) 612-8606
Addresses
Street Address
1900 HOSPITAL BOULEVARD
GAINSVILLE, TX 76240
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2012, terminated 7/1/2019. Reinstated 4/1/2023.
01/23/2023
April 2025
April 2025
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