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DSH450152D METROPLEX HOSPITAL (Terminated)
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Main Details
Name
METROPLEX HOSPITAL
Subdivision Name
Metroplex Home Health Agency
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450152D
Medicare Provider Number
450152
Outpatient Facility Provider Number
677733
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/22/2015
Last Recertification Date
11/3/2017
Termination Date
Termination Reason
10/1/2018
Site closure
Contacts
Authorizing Official
AdventHealth Central Texas
Parker Pridgen, COO/CFO
(254) 519-8165
Primary Contact
Adventh Health Central Texas, AdventHealth Rollins Brooks
Jerry King, Director of Pharmacy
(254) 519-8282
Addresses
Street Address
2115 S. Clear Creek Rd.
Killeen, TX 76549
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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