340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH450237AZ SANTA ROSA HEALTHCARE (Terminated)
Print
Main Details
Name
SANTA ROSA HEALTHCARE
Subdivision Name
CHRISTUS SANTA ROSA HOSPITAL-WESTOV / LDRP
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450237AZ
Medicare Provider Number
450237
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/12/2015
Last Recertification Date
8/31/2016
Termination Date
Termination Reason
1/1/2017
DSH percentage below statutory minimum
Contacts
Authorizing Official
The Children's Hospital of San Antonio
Linda Kirks, Regional VP/CFO
(210) 704-2624
Primary Contact
Christus Health
Dustyn Tysdal, Director of Pharmacy
(830) 643-5377
Addresses
Street Address
11212 STATE HWY 151 BLDG 3
CHRISTUS SANTA ROSA HOSPITAL-WESTOVER HILLS
SAN ANTONIO, TX 78251-4502
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.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
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