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DSH450015AU DALLAS COUNTY HOSPITAL DISTRICT dba PARKLAND HEALTH AND HOSPITAL SYSTEM (Terminated)
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Main Details
Name
DALLAS COUNTY HOSPITAL DISTRICT dba PARKLAND HEALTH AND HOSPITAL SYSTEM
Subdivision Name
Apheresis
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450015AU
Medicare Provider Number
450015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/18/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/8/2016
Last Recertification Date
8/31/2021
Termination Date
Termination Reason
7/1/2022
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Parkland Health
Vivian B. Johnson, Senior Vice President
(469) 419-1946
Primary Contact
Parkland Health
Mayank Shah, Pharmacy 340B Program Manager
(469) 419-1964
Addresses
Street Address
5200 Harry Hines Blvd
Dallas, TX 75235
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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