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DSH450039BT Tarrant County Hospital District d/b/a JPS Health Network (Active)
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Main Details
Name
Tarrant County Hospital District d/b/a JPS Health Network
Subdivision Name
Wound Care Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450039BT
Medicare Provider Number
450039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/6/2016
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Tarrant County Hospital District d/b/a JPS Health Network
Joy Parker, SVP, Operations
(817) 702-5802 Ext: 8177027143
Primary Contact
Tarrant County Hospital District d/b/a/ JPS Health Network
Nicole Shoquist, Chief Pharmacy Officer
(806) 674-2644
Addresses
Street Address
1350 S Main Street
3300
Fort Worth, TX 76104
Billing Address
JPS Health Network Central Fill Pharmacy
1500 S Main St
Fort Worth, TX 76104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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