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SCH450229-16 HENDRICK MEDICAL CENTER (Terminated)
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Main Details
Name
HENDRICK MEDICAL CENTER
Subdivision Name
HMCS Non-Invasive Cardiology - Non-Invasive Cardiology
Type
Sole Community Hospital
Rural
No
340B ID
SCH450229-16
Medicare Provider Number
450229
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/10/2022
Last Recertification Date
Termination Date
Termination Reason
10/1/2022
Change of covered entity type
Contacts
Authorizing Official
Hendrick Medical Center
Jeremy Walker, Chief Financial Officer
(325) 670-2207
Primary Contact
Hendrick Medical Center
Robert Joseph Wray, pharmacist
(325) 670-6405
Addresses
Street Address
6250 US-83
Abilene, TX 79606
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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