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RRC450011-03 ST. JOSEPH REGIONAL HEALTH CENTER (Active)
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Main Details
Name
ST. JOSEPH REGIONAL HEALTH CENTER
Subdivision Name
CHI St Joseph Health Pain & Spine Associates - CHI St Joseph Health Pain & Spine Associates
Type
Rural Referral Center
Rural
No
340B ID
RRC450011-03
Medicare Provider Number
450011
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/4/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/20/2018
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
St. Joseph Regional Health Center
Erin Marietta, VP Operations
(443) 956-3099
Primary Contact
St. Joseph Regional Health Center
Kimberly Feese, Market Director Pharmacy
(979) 776-2506
Addresses
Street Address
2801 Franciscan Drive
Bryan, TX 77802
Billing Address
St. Josph Reg Hlt Ctr
PO Box 2400
Phoenix, AZ 85002
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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