340B Drug Pricing Program Database
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CAH451337-01 Lockney General Hospital District (Active)
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Main Details
Name
Lockney General Hospital District
Subdivision Name
Cogdell Clinic Briscoe County - Cogdell Clinic Briscoe County
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH451337-01
Medicare Provider Number
451337
Outpatient Facility Provider Number
458875
Additional Details
Current Program Status
Active
Registration Date
4/10/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/17/2019
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
W.J. Mangold Memorial Hospital
Vincent DiFranco, CEO
(806) 652-3373 Ext: 204
Primary Contact
W.J. Mangold Memorial Hospital
Amos Poole, Directory of Pharmacy
(806) 652-3373 Ext: 220
Addresses
Street Address
701 Commerce Street
Silverton, TX 79257
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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