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DSH450054DN SCOTT AND WHITE MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
SCOTT AND WHITE MEMORIAL HOSPITAL
Subdivision Name
Baylor Scott & White McLane Children's Medical Center / Peri-op Materials Management
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450054DN
Medicare Provider Number
450054
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/5/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/28/2017
Last Recertification Date
8/24/2019
Termination Date
Termination Reason
10/1/2020
Never implemented the 340B Program
Contacts
Authorizing Official
Baylor Scott & White Medical Center - Temple
Shahin Motakef, CEO
(254) 724-6583
Primary Contact
Scott & White Medical Center - Temple
Sara Rainey, Pharmacy Specialist
(254) 724-2081
Addresses
Street Address
1901 SW HK Dodgen Loop
Temple, TX 76502
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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