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DSH450184DE MEMORIAL HERMANN HOSPITAL SYS (Terminated)
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Main Details
Name
MEMORIAL HERMANN HOSPITAL SYS
Subdivision Name
Memorial Hermann Home Health
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450184DE
Medicare Provider Number
450184
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/5/2015
Last Recertification Date
8/25/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Memorial Hermann System
Rebecca Tucker, VP, Finance
(713) 456-5340
Primary Contact
DAVID STRICKLER, CHIEF FINANCIAL OFFICER
(713) 456-5340
Addresses
Street Address
920 Frostwood
suite 7.100
Houston, TX 77024
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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