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DSH450102D CHRISTUS MOTHER FRANCES HOSP-TYLER (Active)
Main Details
Name
CHRISTUS MOTHER FRANCES HOSP-TYLER
Subdivision Name
CHRISTUS MOTHER FRANCES HOSPITAL - Clinic Services - HealthPark Plaza
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450102D
Medicare Provider Number
450102
Outpatient Facility Provider Number
Contacts
Authorizing Official
CHRISTUS Mother Frances Health System
Eric Garrison, CFO
(903) 606-4102
Primary Contact
Christus Mother Frances, Jacksonville
Joshua Ward, 340B Coordinator
(903) 606-7591
Additional Details
Current Program Status
Active
Registration Date
3/2/2022
Participating Start Date
3/10/2022
Participating Approval Date
3/10/2022
Last Recertification Date
9/11/2023
Addresses
Street Address
1327 TROUP HWY
Tyler, TX 75701
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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