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DSH450039CZ Tarrant County Hospital District d/b/a JPS Health Network (Terminated)
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Main Details
Name
Tarrant County Hospital District d/b/a JPS Health Network
Subdivision Name
Correctional Health - Cold Springs
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450039CZ
Medicare Provider Number
450039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/17/2021
Last Recertification Date
9/7/2022
Termination Date
Termination Reason
7/1/2023
Other
Contacts
Authorizing Official
Tarrant County Hospital District d/b/a JPS Health Network
Joy Parker, SVP, Operations
(817) 702-5802 Ext: 8177027143
Primary Contact
Tarrant County Hospital District d/b/a/ JPS Health Network
Nicole Shoquist, Chief Pharmacy Officer
(806) 674-2644
Addresses
Street Address
1815 Cold Springs Rd
Fort Worth, TX 76196
Billing Address
JPS Health Network Central Fill Pharmacy
1500 S Main St
Fort Worth, TX 75104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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