340B Drug Pricing Program Database
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CAH451371-09 Ascension Seton d/b/a Ascension Seton Edgar B. Davis (Active)
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Main Details
Name
Ascension Seton d/b/a Ascension Seton Edgar B. Davis
Subdivision Name
EBD Lockhart Clinic RHC - RURAL HEALTH CLINIC
Type
Critical Access Hospital
Rural
No
340B ID
CAH451371-09
Medicare Provider Number
451371
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/28/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/2/2020
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Ascension Seton Smithville
Jace D Jones, Authorizing Official
(512) 237-5777
Primary Contact
Ascension Health
Rodrigo Rodriguez, 340B Program Director
(512) 324-9999 Ext: 77031
Addresses
Street Address
630 HWY 71 W
Bastrop, TX 78602-2707
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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