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DSH450424G Houston Methodist Baytown Hospital (Active)
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Main Details
Name
Houston Methodist Baytown Hospital
Subdivision Name
MRI - MRI - OPC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450424G
Medicare Provider Number
450424
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/9/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/6/2020
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Houston Methodist Baytown Hospital
Brett T Brosseau, VICE PRESIDENT / COO
(713) 441-4136
Primary Contact
Houston Methodist
Daniel Metzen, System Director of Pharmacy
(713) 441-2141
Addresses
Street Address
1677 West Baker Road Suite #1220
Baytown, TX 77521
Billing Address
Houston Methodist Baytown
4401 Garth Road
Baytown, TX 77521
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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