340B Drug Pricing Program Database
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DSH450152F AdventHealth Central Texas (Active)
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Main Details
Name
AdventHealth Central Texas
Subdivision Name
ADVENTHEALTH MEDICAL GROUP PSYCHIAT - AdventHealth Medical Group Psychiatry & Psychology at Killeen
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450152F
Medicare Provider Number
450152
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/5/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/15/2020
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
AdventHealth Central Texas
Janet Garcia, Chief Financial Officer
(682) 459-7140
Primary Contact
AdventHealth
Dustin Lott Jones, 340B Coordinator
(254) 833-1495
Addresses
Street Address
2407 S CLEAR CREEK RD
BLDG A, STE 11, 12, 17, 18, 19
KILLEEN, TX 76549-7521
Billing Address
AdventHealth Central Texas
c/o AdventHealth
902 Inspiration Ave
Suite 9100
Altamonte Springs, FL 32714
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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