340B Drug Pricing Program Database
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DSH450801AG CHRISTUS ST MICHAEL (Active)
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Main Details
Name
CHRISTUS ST MICHAEL
Subdivision Name
CHRISTUS St. Michael Orthopedic Surgery Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450801AG
Medicare Provider Number
450801
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2021
Participating Start Date
4/1/2021
Participating Approval Date
2/10/2021
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
CHRISTUS St. Michael
Jason Adams, President
(903) 614-2001
Primary Contact
CHRISTUS St Michael
Carly Armstrong, Coordinator Pharmacy 340B Program
(903) 614-2929
Addresses
Street Address
2602 St. Michael Drive
Suite 302A
Texarkana, TX 75503
Billing Address
CHRISTUS ST MICHAEL
2600 ST MICHAEL DRIVE
TEXARKANA, TX 75503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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