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DSH450015Z Dallas County Hospital District dba Parkland Health & Hospital System (Terminated)
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Main Details
Name
Dallas County Hospital District dba Parkland Health & Hospital System
Subdivision Name
The Bridge Homeless Shelter
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450015Z
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
8/27/2015
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
Parkland Health
Vivian B. Johnson, Senior Vice President
(469) 419-1946
Primary Contact
Parkland Health
Vivian B. Johnson, Senior Vice President
(469) 419-1946
Addresses
Street Address
1818 Corsicana Street
Dallas, TX 75201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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