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SCH450144-01 Andrews Co Hospital District dba Permian Regional Medical Center (Active)
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Main Details
Name
Andrews Co Hospital District dba Permian Regional Medical Center
Subdivision Name
ANDREWS COUNTY HOSPITAL DISTRICT / Quick Care Clinic
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH450144-01
Medicare Provider Number
450144
Outpatient Facility Provider Number
673420
Additional Details
Current Program Status
Active
Registration Date
7/1/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/15/2015
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Permian Regional Medical Center
Morgan Mason, CFO
(432) 464-2107
Primary Contact
Permian Regional Medical Center
Danette Moore, Pharmacy Tech
(432) 464-2132
Addresses
Street Address
1411 N Main St.
ANDREWS, TX 79714-2108
Billing Address
Permian Regional Medical Center
P.O. Box 2108
Andrews, TX 79714
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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