Covered Entity Details

DSH190040 Slidell Memorial Hospital (Active) - information as of 4/28/2025 1:50:08 AM

Main Details

Name

Slidell Memorial Hospital

Subdivision Name

Type

Disproportionate Share Hospital

Rural

340B ID

DSH190040

Medicare Provider Number

190040

Additional Details

Current Program Status

Active

Registration Date

8/30/2011

Participating Start Date

10/1/2011

Participating Approval Date

9/21/2011

Last Recertification Date

8/27/2024

Contacts

Authorizing Official

Slidell Memorial Hospital
Sandy T Badinger, CEO
(504) 881-7056

Primary Contact

Slidell Memorial Hospital
Kisha Gant O'Neal Gant, Director of Pharmacy
(985) 280-7667

Addresses

Street Address

1001 Gause Boulevard
Slidell, LA 70458-2987

Billing Address

Ochsner Clinic Foundation - Accounts Payable
1201 Dickory Ave
New Orleans, LA 70123

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
LA	1720313	1578568481
MS	00020424	1578568481

Shipping Addresses

Shipping Address 1

Slidell Memorial Hospital East
100 Medical Center Dr
Inpatient Pharmacy
Slidell, LA 70461

Shipping Address 2

Safecor Health
4060 Business Park Dr.
Columbus, OH 43204

Shipping Address 3

3PL Ochsner Mckesson
3301 Pollok Dr.
Conroe, TX 77303

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	OCHSNER OUTPATIENT AND HOME INFUSION PHA	4115 JEFFERSON HWY		NEW ORLEANS	LA	70121	04/15/2024	07/01/2024		07/01/2024
Contract Detail	OCHSNER PHARMACY AND WELLNESS - SLIDELL	1051 GAUSE BLVD STE 101		SLIDELL	LA	70458-2951	10/08/2019	01/01/2020		01/01/2020
Contract Detail	OCHSNER PHARMACY AND WELLNESS LLC	DBA OCHSNER SPECIALTY PHARMACY - BATON R	11200 INDUSTRIPLEX BLVD STE 160	BATON ROUGE	LA	70809	07/05/2022	10/01/2022		10/01/2022
Contract Detail	OCHSNER SPECIALTY PHARMACY	1405 JEFFERSON HWY	SUITE A	NEW ORLEANS	LA	70121	10/08/2019	01/01/2020		01/01/2020
Contract Detail	WAL-MART PHARMACY 10-0541	880 NORTH HWY 190		COVINGTON	LA	70433	07/22/2014	10/01/2014	07/01/2016	06/14/2016
Contract Detail	WAL-MART PHARMACY 10-0553	39142 NATCHEZ DR		SLIDELL	LA	70461	07/22/2014	10/01/2014	07/01/2016	06/14/2016
Contract Detail	WAL-MART PHARMACY 10-0909	8101 W. JUDGE PEREZ DR.		CHALMETTE	LA	70043	07/22/2014	10/01/2014	07/01/2016	06/14/2016
Contract Detail	WAL-MART PHARMACY 10-0970	235 FRONTAGE RD		PICAYUNE	MS	39466	07/22/2014	10/01/2014	07/01/2016	06/14/2016
Contract Detail	WAL-MART PHARMACY 10-1195	460 HWY 90		WAVELAND	MS	39576	07/22/2014	10/01/2014	07/01/2016	06/14/2016
Contract Detail	WAL-MART PHARMACY 10-2665	167 NORTHSHORE BLVD.		SLIDELL	LA	70460	07/22/2014	10/01/2014	07/01/2016	06/14/2016
Contract Detail	WAL-MART PHARMACY 10-5832	3009 E CAUSEWAY APPROACH		MANDEVILLE	LA	70448	07/22/2014	10/01/2014	07/01/2016	06/14/2016
Contract Detail	WALGREEN CO		15998 WALGREENS DRIVE	JUPITER	FL	33478	03/13/2013	04/01/2013	07/20/2015	05/03/2016
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 10273	2209 HIGHWAY 11 NORTH	PICAYUNE	MS	39466-2065	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 10290	1505 HIGHWAY 43 S	PICAYUNE	MS	39466-9297	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN CO.	DBA: WALGREENS #10321	348 HIGHWAY 90	WAVELAND	MS	39576-2672	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 04007	1260 FRONT STREET	SLIDELL	LA	70458	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 04285	4142 PONTCHARTRAIN DR	SLIDELL	LA	70458-5138	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 04290	100 N. MILITARY RD.	SLIDELL	LA	70461	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN LOUISIANA CO., INC.	DBA WALGREENS #13876	2180 GAUSE BLVD W	SLIDELL	LA	70460	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 07415	100 W JUDGE PEREZ DRIVE	CHALMETTE	LA	70043-5002	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 06849	2050 FLORIDA STREET	MANDEVILLE	LA	70448	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03440	2880 HIGHWAY 190	MANDEVILLE	LA	70471	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03990	1203 BUSINESS 190	COVINGTON	LA	70433-3278	03/13/2013	04/01/2013		05/03/2016
Contract Detail	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #15988	1051 GAUSE BLVD STE 101	SLIDELL	LA	70458-2951	01/14/2015	04/01/2015	07/31/2019	10/08/2019
Contract Detail	WALGREEN LOUISIANA CO., INC.	WALGREENS #17049	2090 GAUSE BLVD E	SLIDELL	LA	70461-5431	10/08/2019	01/01/2020	11/08/2023	11/10/2023
Contract Detail	Walgreens #21389	Walgreens Central Fill #21389	3299 Tchulatech Dr Suite 101	Memphis	TN	38118	04/11/2022	07/01/2022		07/01/2022
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	04/09/2013	07/01/2013	07/20/2015	05/03/2016
Contract Detail	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	04/09/2013	07/01/2013	07/20/2015	05/03/2016
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	01/14/2015	04/01/2015	08/15/2019	10/08/2019
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	01/14/2015	04/01/2015	08/15/2019	10/08/2019
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	01/14/2015	04/01/2015	08/15/2019	10/08/2019
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	01/14/2015	04/01/2015		05/03/2016

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH190040A	Child	DSH	Slidell Memorial Hospital	Slidell Memorial Hospital Regional Cancer Center	1120 Robert Blvd.	Slidell	LA	Active
DSH190040AA	Child	DSH	Slidell Memorial Hospital	Physical Therapy MC07 - SMEH PHYSICAL THERAPY	100 Medical Center Drive	Slidell	LA	Active
DSH190040AB	Child	DSH	Slidell Memorial Hospital	Electrocardiology MC07 - SMEH EKG/CARDIOLOGY	100 Medical Center Drive	Slidell	LA	Active
DSH190040AC	Child	DSH	Slidell Memorial Hospital	Cardiac Rehab - SMHH CARDIO PULMONARY REHAB	1051 Gause Boulevard	Slidell	LA	Active
DSH190040AD	Child	DSH	Slidell Memorial Hospital	Emergency Med Svcs MC07 - SMEH EMERGENCY DEPARTMENT	100 Medical Center Drive	Slidell	LA	Active
DSH190040AE	Child	DSH	Slidell Memorial Hospital	Wound Care MC08 - SMEH WOUND CARE	100 Medical Center Drive	Slidell	LA	Active
DSH190040AF	Child	DSH	Slidell Memorial Hospital	CT Scan MC07 - SMEH CT SCAN	100 Medical Center Drive	Slidell	LA	Active
DSH190040AG	Child	DSH	Slidell Memorial Hospital	Ultrasonography MC07 - SMEH ULTRASOUND	100 Medical Center Drive	Slidell	LA	Active
DSH190040AH	Child	DSH	Slidell Memorial Hospital	Mammography MC07 - SMEH MAMMOGRAPHY	100 Medical Center Drive	Slidell	LA	Active
DSH190040AJ	Child	DSH	Slidell Memorial Hospital	MRI MC07 - SMEH MRI	100 Medical Center Drive	Slidell	LA	Active
DSH190040AK	Child	DSH	Slidell Memorial Hospital	Nuclear Medicine MC07 - SMEH NUCLEAR MEDICINE	100 Medical Center Drive	Slidell	LA	Active
DSH190040B	Child	DSH	Slidell Memorial Hospital	SMH Imaging-MRI	1495 Gause Blvd	Slidell	LA	Active
DSH190040D	Child	DSH	Slidell Memorial Hospital	Radiology-Diagnostic	1495 GAUSE BLVD	SLIDELL	LA	Active
DSH190040E	Child	DSH	Slidell Memorial Hospital	SMH PRIMARY CARE - Primary Care Clinic	901 GAUSE BLVD	SLIDELL	LA	Terminated
DSH190040F	Child	DSH	Slidell Memorial Hospital	CARDIOLOGY OUTPATIENT DIAGNOSTICS - CARDIOLOGY OUTPATIENT DIAGNOSTICS	1051 GAUSE BLVD	SLIDELL	LA	Active
DSH190040G	Child	DSH	Slidell Memorial Hospital	SMH Imaging CT Scan - SMHH CT SCAN IMAGING CENTER	1495 Gause Boulevard	Slidell	LA	Active
DSH190040H	Child	DSH	Slidell Memorial Hospital	OP Surgery Center MC04 - SMEH ASU PERIOP SERVICES	100 Medical Center Drive	Slidell	LA	Active
DSH190040J	Child	DSH	Slidell Memorial Hospital	Outpatient Surgery MC07 - SMEH PRE/POST-OP	100 Medical Center Drive	Slidell	LA	Active
DSH190040K	Child	DSH	Slidell Memorial Hospital	Endoscopy MC07 - SMEH ENDOSCOPY	100 Medical Center Drive	Slidell	LA	Active
DSH190040L	Child	DSH	Slidell Memorial Hospital	Surg & Recovery Svcs MC07 - SMEH PERIOP SERVICES	100 Medical Center Drive	Slidell	LA	Active
DSH190040M	Child	DSH	Slidell Memorial Hospital	Post Anest Care Unit MC07 - SMEH PACU	100 Medical Center Drive	Slidell	LA	Active
DSH190040N	Child	DSH	Slidell Memorial Hospital	Anesthesiology MC07 - SMEH ANESTHESIOLOGY	100 Medical Center Drive	Slidell	LA	Active
DSH190040P	Child	DSH	Slidell Memorial Hospital	Radiology Intervent MC07 - SMEH INTERVENTIONAL RADIOLOGY	100 Medical Center Drive	Slidell	LA	Active
DSH190040Q	Child	DSH	Slidell Memorial Hospital	Radiology Diagnostic MC07 - SMEH XRAY	100 Medical Center Drive	Slidell	LA	Active
DSH190040R	Child	DSH	Slidell Memorial Hospital	SMH Imaging PET Scan - SMHH PET CT IMAGING CENTER	1495 Gause Boulevard	Slidell	LA	Active
DSH190040S	Child	DSH	Slidell Memorial Hospital	SMH Imaging Radiology - SMHH XRAY IMAGING CENTER	1495 Gause Boulevard	Slidell	LA	Active
DSH190040T	Child	DSH	Slidell Memorial Hospital	SMH Imaging Ultrasound - SMHH ULTRASOUND IMAGING CENTER	1495 Gause Boulevard	Slidell	LA	Active
DSH190040U	Child	DSH	Slidell Memorial Hospital	Laboratory - SMHH IMAGING LAB DRAW STATION	1495 Gause Boulevard	Slidell	LA	Active
DSH190040V	Child	DSH	Slidell Memorial Hospital	Infusion MC07 - SMEH INFUSION	100 Medical Center Drive	Slidell	LA	Active
DSH190040W	Child	DSH	Slidell Memorial Hospital	Pulmonary Funct Svcs MC07 - SMEH PULMONARY FUNCTION SERVICES	100 Medical Center Drive	Slidell	LA	Active
DSH190040X	Child	DSH	Slidell Memorial Hospital	Respiratory Therapy MC07 - SMEH RESPIRATORY THERAPY	100 Medical Center Drive	Slidell	LA	Active
DSH190040Y	Child	DSH	Slidell Memorial Hospital	Occupational Med MC07 - SMEH OCCUPATIONAL THERAPY	100 Medical Center Drive	Slidell	LA	Active
DSH190040Z	Child	DSH	Slidell Memorial Hospital	Speech Lang Path MC07 - SMEH SPEECH THERAPY	100 Medical Center Drive	Slidell	LA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Shipping Address	Insert	Change Request		Safecor Health 4060 Business Park Dr. Columbus, OH 43204	11/19/2024 9:44 AM
Addresses	Shipping Address	Insert	Change Request		3PL Ochsner Mckesson 3301 Pollok Dr. Conroe, TX 77303	11/19/2024 9:44 AM
Details	Last Recertification Date	Update	Recertification	8/14/2023 2:14:20 PM	8/27/2024 6:36:45 PM	8/27/2024 6:36 PM
Contacts	Authorizing Official	Update	AO Change Request	Badinger, Sandy Chief Executive Officer Slidell Memorial Hospital 9852808503	Badinger, Sandy T CEO Slidell Memorial Hospital 5048817056	4/19/2024 2:13 PM
Addresses	Billing Address	Insert	Change Request		Ochsner Clinic Foundation - Accounts Payable 1201 Dickory Ave New Orleans, LA 70123	4/9/2024 6:05 PM
Contacts	Primary Contact	Update	Change Request	Gant, Kisha Pharmacy Director Slidell Memorial Hospital 9852808898	Gant, Kisha Gant O'Neal Director of Pharmacy Slidell Memorial Hospital 9852807667	1/17/2024 9:19 AM
Addresses	Shipping Address	Insert	Change Request		Slidell Memorial Hospital East 100 Medical Center Dr Inpatient Pharmacy Slidell, LA 70461	9/22/2023 3:53 PM
Details	Last Recertification Date	Update	Recertification	9/1/2022 5:46:59 PM	8/14/2023 2:14:20 PM	8/14/2023 2:14 PM
Details	Last Recertification Date	Update	Recertification	8/27/2021 3:21:43 PM	9/1/2022 5:46:59 PM	9/1/2022 5:46 PM
Details	Last Recertification Date	Update	Recertification	8/24/2020 10:58:00 AM	8/27/2021 3:21:43 PM	8/27/2021 3:21 PM
Contacts	Authorizing Official	Update	Profile Change Request	Badinger, Sandy Chief Financial Officer Slidell Memorial Hospital 9852808503	Badinger, Sandy Chief Executive Officer Slidell Memorial Hospital 9852808503	8/27/2020 7:26 PM
Medicaid Billing	NPI: State	Update	Recertification		LA	8/24/2020 10:58 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1578568481	8/24/2020 10:58 AM
Medicaid Billing	NPI: State	Insert	Recertification		MS	8/24/2020 10:58 AM
Details	Last Recertification Date	Update	Recertification	8/21/2019 9:39:41 PM	8/24/2020 10:58:00 AM	8/24/2020 10:58 AM
Contacts	Primary Contact	Update	Change Request	McKendall, Michael Director of Pharmacy Slidell Memorial Hospital 9852808898	Gant, Kisha Pharmacy Director Slidell Memorial Hospital 9852808898	10/8/2019 12:26 PM
Details	Last Recertification Date	Update	Recertification	8/22/2018 11:51:36 AM	8/21/2019 9:39:41 PM	8/21/2019 9:39 PM
Details	Last Recertification Date	Update	Recertification	11/13/2017 12:41:22 PM	8/22/2018 11:51:36 AM	8/22/2018 11:51 AM
Details	Last Recertification Date	Update	Recertification	10/24/2017 11:03:27 AM	11/13/2017 12:41:22 PM	11/13/2017 12:41 PM
Details	Last Recertification Date	Update	Recertification	8/12/2016 12:00:00 AM	10/24/2017 11:03:27 AM	10/24/2017 11:03 AM
Contacts	Authorizing Official	Update		Badinger, Sandy Chief Financial Officer 9852808503	Badinger, Sandy Chief Financial Officer Slidell Memorial Hospital 9852808503	10/11/2017 2:08 PM
Contacts	Primary Contact	Update		McKendall, Michael Director of Pharmacy 9852808898	McKendall, Michael Director of Pharmacy Slidell Memorial Hospital 9852808898	10/9/2017 10:04 AM
Addresses	Main Address	Insert			1001 Gause Boulevard Slidell, LA 70458-2987	8/12/2016 10:23 AM
Contacts	Primary Contact	Insert			McKendall, Michael Director of Pharmacy 9852808898	8/12/2016 10:23 AM
Contacts	Authorizing Official	Insert			Badinger, Sandy Chief Financial Officer 9852808503	8/12/2016 10:23 AM
Contacts	Signed By	Insert			Davis, Bill Chief Financial Officer 9856498504	8/12/2016 10:23 AM
Details	Last Recertification Date	Update		8/5/2015 12:00:00 AM	8/12/2016 12:00:00 AM	8/12/2016 10:23 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/12/2015 11:23 AM
Medicaid Billing	Medicaid: Number	Insert			00020424	11/12/2015 11:23 AM
Medicaid Billing	Medicaid: State	Insert			MS	11/12/2015 11:23 AM
Details	Last Recertification Date	Update		8/18/2014 12:00:00 AM	8/5/2015 12:00:00 AM	8/5/2015 10:32 AM
Details	Last Recertification Date	Update		8/21/2013 12:00:00 AM	8/18/2014 12:00:00 AM	8/18/2014 8:48 AM
Medicaid Billing	NPI: Number	Insert			1578568481	8/21/2013 11:05 AM
Details	Last Recertification Date	Update			8/21/2013 12:00:00 AM	8/21/2013 11:05 AM
Dates	Participating Approval Date	Update			9/21/2011 12:00:00 AM	9/21/2011 12:05 PM
Details	State	Update		Pending	Active	9/21/2011 12:05 PM
Dates	Start Date	Update			10/1/2011 12:00:00 AM	9/21/2011 12:05 PM
Details	340B ID	Update		ONLINE_REG	DSH190040	9/9/2011 12:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	8/30/2011 11:14 AM
Medicaid Billing	Medicaid: Number	Insert			1720313	8/30/2011 11:14 AM
Medicaid Billing	Medicaid: State	Insert			LA	8/30/2011 11:14 AM
Details	Last Recertification Date	Insert				8/30/2011 11:14 AM
Details	Grant Number	Insert				8/30/2011 11:14 AM
Details	340B ID	Insert			ONLINE_REG	8/30/2011 11:14 AM
Details	Is Authorizing Official EHB Data	Insert				8/30/2011 11:14 AM
Dates	Last Date That 340B Drugs Purchased	Insert				8/30/2011 11:14 AM
Details	Medicare Provider Number	Insert			190040	8/30/2011 11:14 AM
Details	Entity Name	Insert			Slidell Memorial Hospital	8/30/2011 11:14 AM
Details	Program Code	Insert			DSH	8/30/2011 11:14 AM
Details	Entity Subname	Insert				8/30/2011 11:14 AM
Dates	Participating Approval Date	Insert				8/30/2011 11:14 AM
Details	State	Insert			Pending	8/30/2011 11:14 AM
Dates	Registration Date	Insert			8/30/2011 12:00:00 AM	8/30/2011 11:14 AM
Dates	Signed By Date	Insert			8/30/2011 12:00:00 AM	8/30/2011 11:14 AM
Dates	Start Date	Insert				8/30/2011 11:14 AM
Terminations	Termination Comments	Insert				8/30/2011 11:14 AM
Terminations	Termination Date	Insert				8/30/2011 11:14 AM
Terminations	Termination Effective Date	Insert				8/30/2011 11:14 AM
Terminations	Termination Reason	Insert				8/30/2011 11:14 AM