340B Drug Pricing Program Database
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DSH450801AM CHRISTUS ST MICHAEL (Active)
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Main Details
Name
CHRISTUS ST MICHAEL
Subdivision Name
CHRISTUS St. Michael Neurology Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450801AM
Medicare Provider Number
450801
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/5/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/15/2022
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
CHRISTUS St. Michael
Jason Adams, President
(903) 614-2001
Primary Contact
CHRISTUS St Michael
Carly Armstrong, Coordinator Pharmacy 340B Program
(903) 614-2929
Addresses
Street Address
5002 Cowhorn Creek Rd.
STE 5033A
Texarkana, TX 75503
Billing Address
CHRISTUS ST MICHAEL
2600 ST MICHAEL DRIVE
TEXARKANA, TX 75503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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