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DSH450046AY CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE (Terminated)
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Main Details
Name
CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE
Subdivision Name
Cancer Center Calallen
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450046AY
Medicare Provider Number
450046
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/5/2015
Last Recertification Date
8/22/2023
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
CHRISTUS Spohn
Becky Rios, Interim CFO
(361) 881-3157
Primary Contact
CHRISTUS Spohn Region
Noreen Adame, Lead Pharmacy Buyer
(361) 902-4326
Addresses
Street Address
14120 Northwest Blvd
Corpus Christi, TX 78405
Billing Address
CHRISTUS Spohn Hospital Corpus Christi
2606 Hospital Blvd.
Corpus Christi, TX 78405
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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