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DSH450330D OAKBEND MEDICAL CENTER (Terminated)
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Main Details
Name
OAKBEND MEDICAL CENTER
Subdivision Name
Hospital of Surgical Excellence-Operating Room
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450330D
Medicare Provider Number
450330
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/28/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/11/2017
Last Recertification Date
9/11/2018
Termination Date
Termination Reason
10/1/2019
Business decision by the Covered Entity
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
1211 HIGHWAY 6
SUGAR LAND, TX 77478-4940
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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