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DSH450039BA TARRANT COUNTY HOSPITAL DISTRICT, JOHN PETER SMITH HOSPITAL (Terminated)
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Main Details
Name
TARRANT COUNTY HOSPITAL DISTRICT, JOHN PETER SMITH HOSPITAL
Subdivision Name
JPS G.I. - ENDOSCOPY CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450039BA
Medicare Provider Number
450039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2014
Participating Start Date
1/1/2015
Participating Approval Date
10/29/2014
Last Recertification Date
9/14/2020
Termination Date
Termination Reason
10/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Tarrant County Hospital District d/b/a JPS Health Network
Karen Scott Duncan, President, CEO JPS Health Network
(817) 702-2318
Primary Contact
Tarrant County Hospital District d/b/a/ JPS Health Network
Nicole Shoquist, Chief Pharmacy Officer
(806) 674-2644
Addresses
Street Address
1741 E. BARDIN RD
ARLINGTON, TX 76018-4836
Billing Address
JPS Health Network Central Fill Pharmacy
1500 S Main St
Fort Worth, TX 76104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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