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RRC450237-19 CHRISTUS SANTA ROSA HEALTH SYSTEM (Terminated)
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Main Details
Name
CHRISTUS SANTA ROSA HEALTH SYSTEM
Subdivision Name
CHRISTUS Santa Rosa Hospital New Braunfels - O/P Chemotherap - Clinic
Type
Rural Referral Center
Rural
No
340B ID
RRC450237-19
Medicare Provider Number
450237
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/16/2018
Participating Start Date
7/1/2018
Participating Approval Date
5/9/2018
Last Recertification Date
8/25/2022
Termination Date
Termination Reason
7/1/2023
Change of covered entity type
Contacts
Authorizing Official
CHRISTUS Santa Rosa
Steve Chen, CFO
(210) 321-8031
Primary Contact
CHRISTUS Hospital Santa Rosa Medical Center
Emmanuel Aniemeke, Director of Pharmacy Services
(210) 705-6193
Addresses
Street Address
Medical Plaza Building, 598 North Union Avenue, 1st Floor
New Braunfels, TX 78130
Billing Address
CHRISTUS Santa Rosa Hospital New Braunfels
600 North Union Avenue
New Braunfels, TX 78130
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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November 2024
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