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CAH451365-02 SETON HIGHLAND LAKE (Terminated)
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Main Details
Name
SETON HIGHLAND LAKE
Subdivision Name
Seton Marble Falls Rehabilitation Center
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH451365-02
Medicare Provider Number
451365
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/3/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/25/2013
Last Recertification Date
8/17/2016
Termination Date
Termination Reason
4/1/2017
Loss of qualifying grant/support
Contacts
Authorizing Official
Seton Healthcare Family
Karen Litterer, VP-COO SHL
(512) 715-3008
Primary Contact
Seton Healthcare Family
Shewan M. Aziz, Senior Network Director of Pharmacy
(512) 324-7303
Addresses
Street Address
700 Hwy 281 N
Ste. A
Marble Falls, TX 78654
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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