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DSH450587 HENDRICK MEDICAL CENTER BROWNWOOD (Terminated)
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Main Details
Name
HENDRICK MEDICAL CENTER BROWNWOOD
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH450587
Medicare Provider Number
450587
Additional Details
Current Program Status
Terminated
Registration Date
7/7/2022
Participating Start Date
10/1/2022
Participating Approval Date
8/24/2022
Last Recertification Date
8/20/2024
Termination Date
Termination Reason
1/1/2025
Change of covered entity type
Contacts
Authorizing Official
Hendrick Medical Center Brownood
Erich Wallschlaeger, Chief Financial Officer
(325) 649-3305
Primary Contact
Hendrick Medical Center
Robert Joseph Wray, pharmacist
(325) 670-6405
Addresses
Street Address
1501 BURNETT RD
BROWNWOOD, TX 76804
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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