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DSH450054JF SCOTT AND WHITE MEMORIAL HOSPITAL (Active)
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Main Details
Name
SCOTT AND WHITE MEMORIAL HOSPITAL
Subdivision Name
Baylor Scott & White Mental Health Clinic - Temple/Psychiatry Fast Access
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH450054JF
Medicare Provider Number
450054
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/6/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/14/2022
Last Recertification Date
8/28/2024
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
810 W U AVE
TEMPLE, TX 76508
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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