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DSH450346F BAPTIST HOSPITALS OF SOUTHEAST TEXAS DBA BAPTIST BEAUMONT HOSPITAL (Active)
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Main Details
Name
BAPTIST HOSPITALS OF SOUTHEAST TEXAS DBA BAPTIST BEAUMONT HOSPITAL
Subdivision Name
Orange / Outpatient Infusion
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450346F
Medicare Provider Number
450346
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/3/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/7/2015
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Baptist Hospitals of Southeast Texas
Bryan Chandler, Chief Operations Officer
(409) 212-5004
Primary Contact
Baptist Hospitals of Southeast Texas
Aily Powell, Administrative Director of Pharmacy
(409) 212-7282
Addresses
Street Address
608 Strickland Dr
10F05
Orange, TX 77630-4717
Billing Address
Baptist Hospitals of Southeast Texas
PO Box 1591
Beaumont, TX 77704
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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