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DSH450034K CHRISTUS HOSPITAL (Terminated)
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Main Details
Name
CHRISTUS HOSPITAL
Subdivision Name
CHRISTUS SOUTHEAST TEXAS St. Mary-Day Surgery
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450034K
Medicare Provider Number
450034
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/12/2015
Last Recertification Date
8/30/2016
Termination Date
Termination Reason
1/1/2018
DSH percentage below statutory minimum
Contacts
Authorizing Official
CHRISTUS Hospital
Paul Trevino, CEO, CHRISTUS Health Southeast Texas
(409) 899-7102
Primary Contact
CHRISTUS Hospital
Tommy Welch, Director of Pharmacy
(409) 899-7042
Addresses
Street Address
3600 GATES BLVD
PORT ARTHUR, TX 77642-3858
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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