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PED453316-09 Children’s Medical Center Plano (Active)
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Main Details
Name
Children’s Medical Center Plano
Subdivision Name
Children's Health Specialty Center Plano Campus / Neuropsychology Day Treatment
Type
Children's Hospital
Rural
No
340B ID
PED453316-09
Medicare Provider Number
453316
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/16/2017
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Children's Health
Robert S. Fries, Chief Financial Officer
(214) 456-8414
Primary Contact
Children's Health
Chris Bradley Geiger, Director Business Operations, Ancillary Services
(214) 456-7437
Addresses
Street Address
7609 Preston Road
P4300
Plano, TX 75024-3214
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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