340B Drug Pricing Program Database
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PED453315-01 Children's Hospital of San Antonio (Terminated)
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Main Details
Name
Children's Hospital of San Antonio
Subdivision Name
Pediatric Multi-Specialty Center Westover Hills
Type
Children's Hospital
Rural
No
340B ID
PED453315-01
Medicare Provider Number
453315
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/2/2016
Last Recertification Date
9/3/2020
Termination Date
Termination Reason
10/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Christus Santa Rosa
Stephanie Parker, VP Finance
(210) 704-3657
Primary Contact
Childrens Hospital of San Antonio
Stephanie Younts, Director of Pharmacy
(210) 704-2935
Addresses
Street Address
11130 CHRISTUS Hills Medical Plaza 3, Suite 312D
San Antonio, TX 78251
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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