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SCH450369-00 CHILDRESS COUNTY HOSPITAL DISTRICT DBA CHILDRESS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
CHILDRESS COUNTY HOSPITAL DISTRICT DBA CHILDRESS REGIONAL MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
Rural
No
340B ID
SCH450369-00
Medicare Provider Number
450369
Additional Details
Current Program Status
Terminated
Registration Date
8/21/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/24/2015
Last Recertification Date
Termination Date
Termination Reason
4/1/2016
Change of covered entity type
Contacts
Authorizing Official
Childress Regional Medical Center
JOHN HENDERSON, CEO
(940) 937-9178
Primary Contact
Childress Regional Medical Center
JOHN HENDERSON, CEO
(940) 937-9178
Addresses
Street Address
901 US Hwy 83
CHILDRESS, TX 79201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/24/15 Hospital previously participated as DSH450369 from 12/6/05 through 9/30/15, converted to a SCH effective 10/1/15
08/24/2015
Hospital previously participated as DSH450369 from 12/6/05 through 9/30/15; converted to a SCH effective 10/1/15.
08/21/2015
Hospital previously participated as DSH450369 from
08/21/2015
May 2025
May 2025
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