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DSH450054GV SCOTT AND WHITE MEMORIAL HOSPITAL (Active)
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Main Details
Name
SCOTT AND WHITE MEMORIAL HOSPITAL
Subdivision Name
Baylor Scott & White Specialty Clinic - Killeen Hemingway/Diagnostic Radiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450054GV
Medicare Provider Number
450054
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/2/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/7/2020
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Baylor Scott & White Medical Center - Temple
Gregory Haralson, President
(254) 724-6583
Primary Contact
Baylor Scott & White Medical Center - Temple
Christy Evans, Mgr Pharmacy
(254) 724-2081
Addresses
Street Address
2405 S CLEAR CREEK RD
KILLEEN, TX 76549
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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