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DSH450844D HOUSTON METHODIST WILLOWBROOK HOSPITAL (Active)
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Main Details
Name
HOUSTON METHODIST WILLOWBROOK HOSPITAL
Subdivision Name
HOUSTON METHODIST WILLOWBROOK AMBUL
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450844D
Medicare Provider Number
450844
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/2/2018
Last Recertification Date
8/13/2024
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
13802 Centerfield Dr. STE 100
Houston, TX 77070-6043
Billing Address
Houston Methodist Willowbrook Hospital
18220 State Highway 249
Houston, TX 77070-4347
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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