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SCH450235-01 GONZALES HEALTHCARE SYSTEMS (Active)
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Main Details
Name
GONZALES HEALTHCARE SYSTEMS
Subdivision Name
Sievers Medical Clinic - Waelder - Rural Health Clinic
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH450235-01
Medicare Provider Number
450235
Outpatient Facility Provider Number
453481
Additional Details
Current Program Status
Active
Registration Date
4/28/2020
Participating Start Date
5/13/2020
Participating Approval Date
5/13/2020
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Gonzales Healthcare Systems
Brandon Anzaldua, CFO/COO
(830) 672-7581
Primary Contact
Gonzales Healthcare Systems
Juli Fayee Clay, Compliance Officer
(830) 672-7581 Ext: 1011
Addresses
Street Address
1818 E US Hwy 90
Waelder, TX 78959
Billing Address
Gonzales Healthcare Systems
P.O Box 587
Gonzales, TX 78629
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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