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DSH450844A HOUSTON METHODIST WILLOWBROOK HOSPITAL (ToBeTerminated)
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Main Details
Name
HOUSTON METHODIST WILLOWBROOK HOSPITAL
Subdivision Name
Houston Methodist Emergency Care Center in Cypress
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450844A
Medicare Provider Number
450844
Outpatient Facility Provider Number
Additional Details
Current Program Status
ToBeTerminated
Registration Date
1/12/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/2/2018
Last Recertification Date
8/13/2024
Termination Date
Termination Reason
7/1/2025
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Houston Methodist Willowbrook Hospital
Julie K Peterson, Vice President/Chief Operating Officer
(281) 737-2115
Primary Contact
Houston Methodist
Daniel Metzen, System Director of Pharmacy
(713) 441-2141
Addresses
Street Address
27560 HIGHWAY 290
Cypress, TX 77433-4909
Billing Address
HOUSTON METHODIST WILLOWBROOK HOSPITAL
18220 STATE HIGHWAY 249
Houston, TX 77070-4347
Comments
Medicaid Billing
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Contract Pharmacies
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