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DSH450330B OAKBEND MEDICAL CENTER (Terminated)
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Main Details
Name
OAKBEND MEDICAL CENTER
Subdivision Name
Grand Parkway Emergency
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450330B
Medicare Provider Number
450330
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/17/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/11/2017
Last Recertification Date
8/20/2019
Termination Date
Termination Reason
10/1/2021
Site closure
Contacts
Authorizing Official
OakBend Medical Center
Jeffrey Hammel, CFO
(281) 341-4881
Primary Contact
OakBend Medical Center
Nikita Rayani, Program Director
(281) 633-4012
Addresses
Street Address
7830 W GRAND PARKWAY S.
RICHMOND, TX 77406-5816
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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