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DSH450034BA CHRISTUS HOSPITAL (Active)
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Main Details
Name
CHRISTUS HOSPITAL
Subdivision Name
CHRISTUS SOUTHEAST TEXAS ORTHOPEDIC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450034BA
Medicare Provider Number
450034
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/8/2022
Participating Start Date
10/1/2022
Participating Approval Date
8/3/2022
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
CHRISTUS Hospital
Paul Trevino, CEO, CHRISTUS Health Southeast Texas
(409) 899-7102
Primary Contact
CHRISTUS Health
Santosh Kalathra, Director of Pharmacy
(409) 236-7042
Addresses
Street Address
3500 HIGHWAY 365
STE A-100
Port Arthur, TX 77642
Billing Address
CHRISTUS Hospital
2830 Calder St.
Beaumont, TX 77702
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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