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DSH450046E CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI MEMORIAL (Terminated)
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Main Details
Name
CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI MEMORIAL
Subdivision Name
CHRISTUS Spohn Family Health Center - Northside
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450046E
Medicare Provider Number
450046
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
5/31/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/27/2012
Last Recertification Date
12/4/2017
Termination Date
Termination Reason
10/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
CHRISTUS Spohn
Becky Rios, Interim CFO
(361) 881-3157
Primary Contact
CHRISTUS Spohn Health System
Deborah Allen, Director of Pharmacy
(361) 902-6721
Addresses
Street Address
1406 Martin Luther King Drive
Corpus Christi, TX 78401-1700
Billing Address
CHRISTUS Spohn Hospital Corpus Christi
2606 Hospital Blvd.
Corpus Christi, TX 78405
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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