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DSH450844 HOUSTON METHODIST WILLOWBROOK HOSPITAL (Active)
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Main Details
Name
HOUSTON METHODIST WILLOWBROOK HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450844
Medicare Provider Number
450844
Additional Details
Current Program Status
Active
Registration Date
1/4/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/2/2018
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Houston Methodist Willowbrook Hospital
Julie K Peterson, Vice President/Chief Operating Officer
(281) 737-2115
Primary Contact
Houston Methodist
Daniel Metzen, System Director of Pharmacy
(713) 441-2141
Addresses
Street Address
18220 STATE HIGHWAY 249
HOUSTON, TX 77070-4347
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2015, terminated 10/1/2015. Reinstated 4/1/2018.
01/26/2018
May 2025
May 2025
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