340B Drug Pricing Program Database
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DSH450801D CHRISTUS ST MICHAEL (Terminated)
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Main Details
Name
CHRISTUS ST MICHAEL
Subdivision Name
Senior Health Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450801D
Medicare Provider Number
450801
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/12/2015
Last Recertification Date
9/7/2021
Termination Date
Termination Reason
10/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
CHRISTUS St. Michael
Jason Adams, President
(903) 614-2001
Primary Contact
Christus St Michael Healthcare System
Pamela Kay Spraggins, Coordinator Government pharmacy 340b program
(903) 614-2929
Addresses
Street Address
2604 SAINT MICHAEL DRIVE, STE 239
CHRISTUS ST MICHAEL SENIOR HEALTH CENTER
TEXARKANA, TX 75503-2378
Billing Address
CHRISTUS St. Michael Health System
2600 St. Michael Dr.
Texarkana, TX 75503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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