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CHRISTUS SPECIALTY PHARMACY
DSH320004 CHRISTUS Southern New Mexico
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Covered Entity Details
Entity Name
CHRISTUS Southern New Mexico
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH320004
Entity Address
2669 SCENIC DR
ALAMOGORDO, NM 88310-8734
Medicare Provider Number
320004
Participating Start Date
4/1/2015
Last Recertification Date
9/10/2024
Pharmacy Details
Pharmacy Name
CHRISTUS SPECIALTY PHARMACY
Pharmacy Address
MOTHER FRANCES REGIONAL HEALTH CARE CTR
800 E DAWSON ST STE 100
TYLER, TX 75701-2036
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bashar Naser, CFO
(575) 443-7848 Ext: 5754437841
Contract Pharmacy Representative
CHRISTUS Health
Justin Simon, Corporate Director of Pharmacy - Business Services
(214) 704-9531
Signed By Date
10/16/2023
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