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RRC450023-01 CITIZENS MEDICAL CENTER (Active)
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Main Details
Name
CITIZENS MEDICAL CENTER
Subdivision Name
CITIZENS HEALTH PLEX - Physical Rehab
Type
Rural Referral Center
Rural
No
340B ID
RRC450023-01
Medicare Provider Number
450023
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/7/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/24/2023
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
Citizens Medical Center
Duane L. Woods, CFO
(361) 572-5009
Primary Contact
Citizens Medical Center
Michael Casas, Directory of Pharmacy
(361) 572-5071
Addresses
Street Address
9406 NE ZAC LENTZ PKWY
VICTORIA, TX 77904-3108
Billing Address
Citizens Medical Center
2701 Hospital Drive
Victoria, TX 77901
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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