340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH450037B GOOD SHEPHERD MEDICAL CENTER (Terminated)
Print
Main Details
Name
GOOD SHEPHERD MEDICAL CENTER
Subdivision Name
Good Shepherd Medicine Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450037B
Medicare Provider Number
450037
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/9/2013
Last Recertification Date
8/12/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
Christus Good Shepherd Medical Center
Jason Adams, COO
(903) 315-2440
Primary Contact
RON SHORT, EXECUTIVE VICE PRESIDENT/CAO
(903) 315-1121
Addresses
Street Address
103 W Loop 281
Suite 700
Longview, TX 75604
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session