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DSH450015AK DALLAS COUNTY HOSPITAL DISTRICT dba PARKLAND HEALTH AND HOSPITAL SYSTEM (Terminated)
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Main Details
Name
DALLAS COUNTY HOSPITAL DISTRICT dba PARKLAND HEALTH AND HOSPITAL SYSTEM
Subdivision Name
Eddie B. Johnson at Billy Earl Dade YFC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450015AK
Medicare Provider Number
450015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/11/2013
Last Recertification Date
9/2/2021
Termination Date
Termination Reason
10/1/2022
Site closure
Contacts
Authorizing Official
Parkland Health
Vivian B. Johnson, Senior Vice President
(469) 419-1946
Primary Contact
Parkland Health
Mayank Shah, Pharmacy 340B Program Manager
(469) 419-1964
Addresses
Street Address
2727 Al Lipscomb Way
Dallas, TX 75215
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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