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RRC450011-33 ST. JOSEPH REGIONAL HEALTH CENTER (Active)
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Main Details
Name
ST. JOSEPH REGIONAL HEALTH CENTER
Subdivision Name
SJH - COLLEGE STATION DIALYSIS - DIALYSIS
Type
Rural Referral Center
Rural
No
340B ID
RRC450011-33
Medicare Provider Number
450011
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/6/2022
Participating Start Date
1/1/2023
Participating Approval Date
10/31/2022
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
St. Joseph Regional Health Center
Erin Marietta, VP Operations
(443) 956-3099
Primary Contact
St. Joseph Regional Health Center
Kimberly Feese, Market Director Pharmacy
(979) 776-2506
Addresses
Street Address
1604 ROCK PRAIRIE RD
COLLEGE STATION, TX 77845
Billing Address
ST JOSPH REG HLT CTR
PO BOX 2400
Phoenix, AZ 85002
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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