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DSH450046S CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE (Terminated)
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Main Details
Name
CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE
Subdivision Name
Shoreline - Radiolo-Diagnos
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450046S
Medicare Provider Number
450046
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2013
Participating Start Date
4/1/2013
Participating Approval Date
3/11/2013
Last Recertification Date
8/25/2021
Termination Date
Termination Reason
10/1/2022
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
CHRISTUS Spohn
Becky Rios, Interim CFO
(361) 881-3157
Primary Contact
CHRISTUS Spohn Hospital Corpus Christi
Gina Rodriguez, Lead Technician
(361) 902-4375
Addresses
Street Address
600 Elizabeth Street
Corpus Christi, TX 78404
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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