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SCH450219-00 Baylor Scott & White Medical Center - Llano (Terminated)
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Main Details
Name
Baylor Scott & White Medical Center - Llano
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH450219-00
Medicare Provider Number
450219
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2013
Participating Start Date
10/1/2013
Participating Approval Date
8/27/2013
Last Recertification Date
9/6/2016
Termination Date
Termination Reason
4/1/2017
DSH percentage below statutory minimum
Contacts
Authorizing Official
Bramer Owens, COO
(830) 201-7353
Primary Contact
Jennifer Lockmiller, Director, Pharmacy
(325) 248-2124
Addresses
Street Address
200 W. Ollie St.
Llano, TX 78643
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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