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DSH450229 HENDRICK MEDICAL CENTER (Active)
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Main Details
Name
HENDRICK MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450229
Medicare Provider Number
450229
Additional Details
Current Program Status
Active
Registration Date
7/12/2022
Participating Start Date
10/1/2022
Participating Approval Date
8/4/2022
Last Recertification Date
8/20/2024
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
1900 Pine Street
ABILENE, TX 79601-2432
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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