Covered Entity Details

DSH190046G TOURO INFIRMARY (Active) - information as of 4/27/2025 12:53:47 AM

Main Details

Name

TOURO INFIRMARY

Subdivision Name

Internal Medicine, Cardiovascular, Family Practice and OBGYN

Type

Disproportionate Share Hospital

Rural

340B ID

DSH190046G

Medicare Provider Number

190046

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

11/17/2011

Participating Start Date

1/1/2012

Participating Approval Date

12/15/2011

Last Recertification Date

9/5/2024

Contacts

Authorizing Official

Touro Infirmary
Candace Robinson, Chief Medical Officer
(504) 897-8246

Primary Contact

Touro Infirmary
Tara Montgomery, Director of Pharmacy
(504) 897-8071 Ext: 7515

Addresses

Street Address

5646 Read BLVD
Suite 280
New Orleans, LA 70127

Billing Address

Touro Infirmary
1401 FOUCHER STREET
NEW ORLEANS, LA 70115

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	1720470	1821098286

Shipping Addresses

Shipping Address 1

1401 FOUCHER STREET
NEW ORLEANS, LA 70115

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH190046AA	Child	DSH	TOURO INFIRMARY	CCPI FAMILY PRACTICE & OBGYN - Hematology and Oncology	145 ROBERT E LEE BLVD	NEW ORLEANS	LA	Terminated
DSH190046AB	Child	DSH	TOURO INFIRMARY	CCPI HEMATOLOGY AND ONCOLOGY - Hematology and Oncology	3712 Mac Arthur Blvd.	New Orleans	LA	Terminated
DSH190046AC	Child	DSH	TOURO INFIRMARY	Internal Medicine - Internal Medicine	3525 Prytania Street	New Orleans	LA	Terminated
DSH190046AD	Child	DSH	TOURO INFIRMARY	Ridgelake 4th Floor - Oncology Infusion Clinic	2121 Ridgelake Drive	Metairie	LA	Active
DSH190046C	Child	DSH	TOURO INFIRMARY	Internal Medicine and OBGYN	4000 Bienville Street	New Orleans	LA	Terminated
DSH190046D	Child	DSH	TOURO INFIRMARY	Family Practice and OBGYN	145 Robert E Lee BLVD	New Orleans	LA	Terminated
DSH190046E	Child	DSH	TOURO INFIRMARY	Family Practice and OBGYN	3322 St.Claude Ave	New Orleans	LA	Terminated
DSH190046F	Child	DSH	TOURO INFIRMARY	Internal Medicine Cardiology and OBGYN	3712 Mac Arthur Blvd	New Orleans	LA	Terminated
DSH190046G	Child	DSH	TOURO INFIRMARY	Internal Medicine, Cardiovascular, Family Practice and OBGYN	5646 Read BLVD	New Orleans	LA	Active
DSH190046H	Child	DSH	TOURO INFIRMARY	Cardiovascular	3715 Prytania STREET	New Orleans	LA	Active
DSH190046J	Child	DSH	TOURO INFIRMARY	Primary and Specialty	3434 Prytania Street, Suite 105	New Orleans	LA	Active
DSH190046K	Child	DSH	TOURO INFIRMARY	OBGYN	3434 Prytania Street, Suite 130	New Orleans	LA	Active
DSH190046M	Child	DSH	TOURO INFIRMARY	Internal Medicine	3434 Prytania Street Suite 460	New Orleans	LA	Active
DSH190046N	Child	DSH	TOURO INFIRMARY	Internal Medicine	3434 Prytania Street, Suite 110	New Orleans	LA	Active
DSH190046P	Child	DSH	TOURO INFIRMARY	OBGYN	3434 Prytania Street, Suite 320	New Orleans	LA	Active
DSH190046Q	Child	DSH	TOURO INFIRMARY	OBGYN	3525 Prytania Street, Suite 224	New Orleans	LA	Active
DSH190046R	Child	DSH	TOURO INFIRMARY	OBGYN	3525 Prytania Street, Suite 206	New Orleans	LA	Active
DSH190046S	Child	DSH	TOURO INFIRMARY	Touro Ambulatory Surgery Center	3525 Prytania Street, Suite 102	New Orleans	LA	Active
DSH190046T	Child	DSH	TOURO INFIRMARY	Touro Imaging Center	2929 Napoleon Ave.	New Orleans	LA	Active
DSH190046U	Child	DSH	TOURO INFIRMARY	Touro Head & Neck Clinic	3700 St. Charles Ave., Suite 700	New Orleans	LA	Terminated
DSH190046V	Child	DSH	TOURO INFIRMARY	Internal Medicine, OBGYN	701 Metairie Rd., Suite 1A-205	Metairie	LA	Active
DSH190046W	Child	DSH	TOURO INFIRMARY	CCPI UROLOGY	3434 Prytania St, Suite 450	New Orleans	LA	Active
DSH190046X	Child	DSH	TOURO INFIRMARY	CCPI INTERNAL MEDICINE	3525 PRYTANIA ST, SUITE 620	NEW ORLEANS	LA	Active
DSH190046Y	Child	DSH	TOURO INFIRMARY	General Surgery - General Surgery	5646 Read Blvd, Suite 280	New Orleans	LA	Active
DSH190046Z	Child	DSH	TOURO INFIRMARY	Gynecologic Oncology - Gynecologic Oncology	3434 Prytania Street	New Orleans	LA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	AO Change Request	Baldwin, Stephen Matthew Chief Operating Officer Touro Infirmary 5048978566	Robinson, Candace Chief Medical Officer Touro Infirmary 5048978246	12/4/2024 11:18 AM
Details	Last Recertification Date	Update	Recertification	9/5/2023 11:01:28 AM	9/5/2024 7:40:11 AM	9/5/2024 7:40 AM
Details	Last Recertification Date	Update	Recertification	9/9/2022 9:52:02 AM	9/5/2023 11:01:28 AM	9/5/2023 11:01 AM
Addresses	Main Address	Update	Recertification	5646 Read Blvd. Suite 280 New Orleans, LA 70127	5646 Read BLVD Suite 280 New Orleans, LA 70127	9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	407357 (AZ)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	197961548A (GA)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	107848701 (TX)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	902734300 (FL)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	220448 (MS)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1512664 (TN)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	226434661A (GA)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1821098286 (NC)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1821098286w (WI)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	2016259523 (VA)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1025142 (VT)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	102252959 (PA)		9/9/2022 9:52 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1821098286 (NV)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (PA)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (VT)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (TX)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (NC)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (TN)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (NV)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (WI)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (VA)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (MS)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (GA)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (AZ)		9/9/2022 9:52 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 (FL)		9/9/2022 9:52 AM
Details	Last Recertification Date	Update	Recertification	9/9/2021 2:44:25 PM	9/9/2022 9:52:02 AM	9/9/2022 9:52 AM
Addresses	Main Address	Update	Recertification	5646 Read Blvd. 280 New Orleans, LA 70127	5646 Read Blvd. Suite 280 New Orleans, LA 70127	9/9/2021 2:44 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/9/2021 2:44 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		197961548A	9/9/2021 2:44 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		GA	9/9/2021 2:44 PM
Details	Last Recertification Date	Update	Recertification	9/4/2020 11:33:52 PM	9/9/2021 2:44:25 PM	9/9/2021 2:44 PM
Addresses	Main Address	Update	Recertification	5646 Read Blvd Suite 280 New Orleans, LA 70127	5646 Read Blvd. 280 New Orleans, LA 70127	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1821098286 ( )		9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		PA	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		VT	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		NC	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		TN	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		LA	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		NV	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		WI	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		VA	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		MS	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		GA	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		AZ	9/4/2020 11:33 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821098286	9/4/2020 11:33 PM
Medicaid Billing	NPI: State	Insert	Recertification		FL	9/4/2020 11:33 PM
Details	Last Recertification Date	Update	Recertification	9/9/2019 3:03:57 PM	9/4/2020 11:33:52 PM	9/4/2020 11:33 PM
Addresses	Main Address	Update	Recertification	5646 Read Blvd, Suite 280 280 New Orleans, LA 70127	5646 Read Blvd Suite 280 New Orleans, LA 70127	9/9/2019 3:03 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/9/2019 3:03 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		407357	9/9/2019 3:03 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		AZ	9/9/2019 3:03 PM
Details	Last Recertification Date	Update	Recertification	9/6/2018 2:04:22 PM	9/9/2019 3:03:57 PM	9/9/2019 3:03 PM
Contacts	Authorizing Official	Update	AO Change Request	Andrews, Susan President & CEO Touro Infirmary 5048978247	Baldwin, Stephen Matthew Chief Operating Officer Touro Infirmary 5048978566	2/26/2019 5:15 PM
Details	Last Recertification Date	Update	Recertification	11/15/2017 9:22:42 PM	9/6/2018 2:04:22 PM	9/6/2018 2:04 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	4/10/2018 10:57 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1821098286	4/10/2018 10:57 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NV	4/10/2018 10:57 AM
Addresses	Main Address	Update	Recertification	9801 Lake Forest Blvd New Orleans, LA 70127	5646 Read Blvd, Suite 280 280 New Orleans, LA 70127	11/15/2017 9:22 PM
Medicaid Billing	Medicaid: Number	Update	Recertification	1821098286	2016259523	11/15/2017 9:22 PM
Details	Last Recertification Date	Update	Recertification	8/17/2016 12:00:00 AM	11/15/2017 9:22:42 PM	11/15/2017 9:22 PM
Contacts	Authorizing Official	Update		Andrews, Susan President & CEO 5048978247	Andrews, Susan President & CEO Touro Infirmary 5048978247	10/9/2017 11:56 AM
Contacts	Primary Contact	Update		Montgomery, Tara Director of Pharmacy 5048978071	Montgomery, Tara Director of Pharmacy Touro Infirmary 5048978071-7515	9/19/2017 2:00 PM
Contacts	Signed By	Insert			Montgomery, James T. President/CEO 5048978246	6/28/2017 3:04 PM
Contacts	Authorizing Official	Insert			Andrews, Susan President & CEO 5048978247	6/28/2017 3:03 PM
Addresses	Main Address	Update		5646 Read Blvd., Suite 280 New Orleans, LA 70127	9801 Lake Forest Blvd New Orleans, LA 70127	4/19/2017 11:01 AM
Addresses	Main Address	Insert			5646 Read Blvd., Suite 280 New Orleans, LA 70127	4/19/2017 11:01 AM
Addresses	Billing Address	Insert			Touro Infirmary 1401 FOUCHER STREET NEW ORLEANS, LA 70115	4/19/2017 11:01 AM
Addresses	Shipping Address	Insert			1401 FOUCHER STREET NEW ORLEANS, LA 70115	4/19/2017 11:01 AM
Contacts	Primary Contact	Update		Henry, Daniel 340b Program Coordinator 5048977515	Montgomery, Tara Director of Pharmacy 5048978071	4/19/2017 11:01 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	4/19/2017 11:00 AM
Medicaid Billing	Medicaid: Number	Insert			102252959	4/19/2017 11:00 AM
Medicaid Billing	Medicaid: State	Insert			PA	4/19/2017 11:00 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	1/12/2017 12:24 PM
Medicaid Billing	Medicaid: Number	Insert			1821098286	1/12/2017 12:24 PM
Medicaid Billing	Medicaid: State	Insert			VA	1/12/2017 12:24 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	1/12/2017 12:24 PM
Medicaid Billing	Medicaid: Number	Insert			1025142	1/12/2017 12:24 PM
Medicaid Billing	Medicaid: State	Insert			VT	1/12/2017 12:24 PM
Contacts	Primary Contact	Update		Hankins, Lee Director of Pharmacy 5048978071	Henry, Daniel 340b Program Coordinator 5048977515	11/2/2016 3:29 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: Number	Insert			1512664	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: State	Insert			TN	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: Number	Insert			226434661A	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: State	Insert			GA	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: Number	Insert			1821098286	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: State	Insert			NC	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: Number	Insert			1821098286w	8/17/2016 5:48 PM
Medicaid Billing	Medicaid: State	Insert			WI	8/17/2016 5:48 PM
Details	Last Recertification Date	Update		9/2/2015 12:00:00 AM	8/17/2016 12:00:00 AM	8/17/2016 5:48 PM
Contacts	Primary Contact	Insert			Hankins, Lee Director of Pharmacy 5048978071	9/21/2015 1:21 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	9/2/2015 11:52 AM
Medicaid Billing	Medicaid: Number	Insert			107848701	9/2/2015 11:52 AM
Medicaid Billing	Medicaid: State	Insert			TX	9/2/2015 11:52 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	9/2/2015 11:52 AM
Medicaid Billing	Medicaid: Number	Insert			902734300	9/2/2015 11:52 AM
Medicaid Billing	Medicaid: State	Insert			FL	9/2/2015 11:52 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	9/2/2015 11:52 AM
Medicaid Billing	Medicaid: Number	Insert			220448	9/2/2015 11:52 AM
Medicaid Billing	Medicaid: State	Insert			MS	9/2/2015 11:52 AM
Details	Last Recertification Date	Update		8/28/2014 12:00:00 AM	9/2/2015 12:00:00 AM	9/2/2015 11:52 AM
Details	Last Recertification Date	Update		8/21/2013 12:00:00 AM	8/28/2014 12:00:00 AM	8/28/2014 1:53 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	8/21/2013 10:53 AM
Medicaid Billing	Medicaid: Number	Insert			1720470	8/21/2013 10:53 AM
Medicaid Billing	Medicaid: State	Insert			LA	8/21/2013 10:53 AM
Medicaid Billing	NPI: Number	Insert			1821098286	8/21/2013 10:53 AM
Details	Last Recertification Date	Update			8/21/2013 12:00:00 AM	8/21/2013 10:53 AM
Dates	Participating Approval Date	Update			12/15/2011 12:00:00 AM	12/15/2011 3:56 PM
Details	State	Update		Pending	Active	12/15/2011 3:56 PM
Dates	Start Date	Update			1/1/2012 12:00:00 AM	12/15/2011 3:56 PM
Details	340B ID	Update		EMG_Touro_5	DSH190046G	12/14/2011 2:48 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG	EMG_Touro_5	12/14/2011 11:24 AM
Details	Entity Subname	Update		CCPI - 9801 Lake Forest Blvd	Internal Medicine, Cardiovascular, Family Practice and OBGYN	12/14/2011 11:24 AM
Details	Last Recertification Date	Insert				11/17/2011 11:33 AM
Details	Grant Number	Insert				11/17/2011 11:33 AM
Details	340B ID	Insert			OUTPATIENT_ONLINE_REG	11/17/2011 11:33 AM
Details	Is Authorizing Official EHB Data	Insert				11/17/2011 11:33 AM
Dates	Last Date That 340B Drugs Purchased	Insert				11/17/2011 11:33 AM
Details	Medicare Provider Number	Insert			190046	11/17/2011 11:33 AM
Details	Entity Name	Insert			TOURO INFIRMARY	11/17/2011 11:33 AM
Details	Program Code	Insert			DSH	11/17/2011 11:33 AM
Details	Entity Subname	Insert			CCPI - 9801 Lake Forest Blvd	11/17/2011 11:33 AM
Dates	Participating Approval Date	Insert				11/17/2011 11:33 AM
Details	State	Insert			Pending	11/17/2011 11:33 AM
Dates	Registration Date	Insert			11/17/2011 12:00:00 AM	11/17/2011 11:33 AM
Dates	Signed By Date	Insert			11/17/2011 12:00:00 AM	11/17/2011 11:33 AM
Dates	Start Date	Insert				11/17/2011 11:33 AM
Terminations	Termination Comments	Insert				11/17/2011 11:33 AM
Terminations	Termination Date	Insert				11/17/2011 11:33 AM
Terminations	Termination Effective Date	Insert				11/17/2011 11:33 AM
Terminations	Termination Reason	Insert				11/17/2011 11:33 AM