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SCH450235-02 GONZALES HEALTHCARE SYSTEMS (Active)
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Main Details
Name
GONZALES HEALTHCARE SYSTEMS
Subdivision Name
GONZALES HEALTHCARE SYSTEMS - Sievers Medical Clinic - Shiner
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH450235-02
Medicare Provider Number
450235
Outpatient Facility Provider Number
673488
Additional Details
Current Program Status
Active
Registration Date
1/13/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/20/2022
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
207 W 7TH ST
SIEVERS MEDICAL CLINIC - SHINER
SHINER, TX 77984-5873
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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