Covered Entity Details

DSH190046U TOURO INFIRMARY (Terminated) - information as of 4/25/2025 6:33:42 PM

Main Details

Name

TOURO INFIRMARY

Subdivision Name

Touro Head & Neck Clinic

Type

Disproportionate Share Hospital

Rural

340B ID

DSH190046U

Medicare Provider Number

190046

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

7/12/2013

Participating Start Date

10/1/2013

Participating Approval Date

9/12/2013

Last Recertification Date

9/2/2015

Termination Date
Termination Reason

7/1/2016
Site closure

Contacts

Authorizing Official

Touro Infirmary
Stephen Matthew Baldwin, Chief Operating Officer
(504) 897-8566

Primary Contact

Daniel Henry, 340b Program Coordinator
(504) 897-7515

Addresses

Street Address

3700 St. Charles Ave., Suite 700
New Orleans, LA 70115

Billing Address

Touro Infirmary
1401 Foucher St.
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
TX	107848701
FL	902734300
MS	220448

Shipping Addresses

Shipping Address 1

Touro Infirmary
1401 Foucher St.
New Orleans, FL 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	Andrews, Susan President & CEO Touro Infirmary 5048978247	Baldwin, Stephen Matthew Chief Operating Officer Touro Infirmary 5048978566	2/26/2019 5:15 PM
Contacts	Authorizing Official	Update		Andrews, Susan President & CEO 5048978247	Andrews, Susan President & CEO Touro Infirmary 5048978247	10/9/2017 11:56 AM
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
Contacts	Primary Contact	Update		Hankins, Lee Director of Pharmacy 5048978071	Henry, Daniel 340b Program Coordinator 5048977515	11/2/2016 3:29 PM
Addresses	Main Address	Insert			3700 St. Charles Ave., Suite 700 New Orleans, LA 70115	5/27/2016 8:49 AM
Addresses	Billing Address	Insert			Touro Infirmary 1401 Foucher St. New Orleans, LA 70115	5/27/2016 8:49 AM
Addresses	Shipping Address	Insert			Touro Infirmary 1401 Foucher St. New Orleans, FL 70115	5/27/2016 8:49 AM
Dates	Last Date That 340B Drugs Purchased	Update			1/31/2016 12:00:00 AM	5/27/2016 8:49 AM
Details	State	Update		Active	Terminated	5/27/2016 8:49 AM
Terminations	Termination Date	Update			7/1/2016 12:00:00 AM	5/27/2016 8:49 AM
Terminations	Termination Effective Date	Update			3/15/2016 12:00:00 AM	5/27/2016 8:49 AM
Terminations	Termination Reason	Update			Site closure	5/27/2016 8:49 AM
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 11:53 AM
Medicaid Billing	Medicaid: Number	Insert			107848701	9/2/2015 11:53 AM
Medicaid Billing	Medicaid: State	Insert			TX	9/2/2015 11:53 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	9/2/2015 11:53 AM
Medicaid Billing	Medicaid: Number	Insert			902734300	9/2/2015 11:53 AM
Medicaid Billing	Medicaid: State	Insert			FL	9/2/2015 11:53 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	9/2/2015 11:53 AM
Medicaid Billing	Medicaid: Number	Insert			220448	9/2/2015 11:53 AM
Medicaid Billing	Medicaid: State	Insert			MS	9/2/2015 11:53 AM
Details	Last Recertification Date	Update		8/28/2014 12:00:00 AM	9/2/2015 12:00:00 AM	9/2/2015 11:53 AM
Details	Last Recertification Date	Update			8/28/2014 12:00:00 AM	8/28/2014 1:53 PM
Details	340B ID	Update		ISJMDSH190046U	DSH190046U	9/12/2013 10:29 AM
Dates	Participating Approval Date	Update			9/12/2013 12:00:00 AM	9/12/2013 10:29 AM
Details	State	Update		Pending	Active	9/12/2013 10:29 AM
Dates	Start Date	Update			10/1/2013 12:00:00 AM	9/12/2013 10:29 AM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG	ISJMDSH190046U	8/3/2013 10:13 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	7/12/2013 4:19 PM
Medicaid Billing	Medicaid: Number	Insert			1720470	7/12/2013 4:19 PM
Medicaid Billing	Medicaid: State	Insert			LA	7/12/2013 4:19 PM
Details	Last Recertification Date	Insert				7/12/2013 4:19 PM
Details	Grant Number	Insert				7/12/2013 4:19 PM
Details	340B ID	Insert			OUTPATIENT_ONLINE_REG	7/12/2013 4:19 PM
Details	Is Authorizing Official EHB Data	Insert				7/12/2013 4:19 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/12/2013 4:19 PM
Details	Medicare Provider Number	Insert			190046	7/12/2013 4:19 PM
Details	Entity Name	Insert			TOURO INFIRMARY	7/12/2013 4:19 PM
Details	Program Code	Insert			DSH	7/12/2013 4:19 PM
Details	Entity Subname	Insert			Touro Head & Neck Clinic	7/12/2013 4:19 PM
Dates	Participating Approval Date	Insert				7/12/2013 4:19 PM
Details	State	Insert			Pending	7/12/2013 4:19 PM
Dates	Registration Date	Insert			7/12/2013 12:00:00 AM	7/12/2013 4:19 PM
Dates	Signed By Date	Insert			7/12/2013 12:00:00 AM	7/12/2013 4:19 PM
Dates	Start Date	Insert				7/12/2013 4:19 PM
Terminations	Termination Comments	Insert				7/12/2013 4:19 PM
Terminations	Termination Date	Insert				7/12/2013 4:19 PM
Terminations	Termination Effective Date	Insert				7/12/2013 4:19 PM
Terminations	Termination Reason	Insert				7/12/2013 4:19 PM