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DSH450054HS SCOTT AND WHITE MEMORIAL HOSPITAL (Active)
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Main Details
Name
SCOTT AND WHITE MEMORIAL HOSPITAL
Subdivision Name
Baylor Scott & White McLane Children's Specialty Clinic - Waco Hillcrest/Nephrology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450054HS
Medicare Provider Number
450054
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2022
Participating Start Date
10/1/2022
Participating Approval Date
8/19/2022
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Baylor Scott & White Medical Center - Temple
Gregory Haralson, President
(254) 724-6583
Primary Contact
Baylor Scott & White Medical Center - Temple
Christy Evans, Mgr Pharmacy
(254) 724-2081
Addresses
Street Address
120 HILLCREST MEDICAL BLVD
WACO, TX 76712
Billing Address
SCOTT AND WHITE MEMORIAL HOSPITAL
2401 S 31st St
Temple, TX 76508
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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