Covered Entity Details

SCH190007-02 NATCHITOCHES REGIONAL MEDICAL CENTER (Terminated) - information as of 6/28/2025 12:26:38 AM

Main Details

Name

NATCHITOCHES REGIONAL MEDICAL CENTER

Subdivision Name

NRMC Walk-In Clinic

Type

Sole Community Hospital

Rural

340B ID

SCH190007-02

Medicare Provider Number

190007

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

7/8/2016

Participating Start Date

10/1/2016

Participating Approval Date

8/8/2016

Last Recertification Date

9/4/2018

Termination Date
Termination Reason

7/1/2019
Business decision by the Covered Entity

Contacts

Authorizing Official

Natchitoches Regional Medical Center
Damian K. Soileau, CEO
(318) 214-4512

Primary Contact

Natchitoches Regional Medical Center
Anne Powell, Director of Pharmacy
(318) 214-4359

Addresses

Street Address

740 Keyser Avenue
Natchitoches Regional Medical Center Walk-In Clinic
Natchitoches, LA 71457

Billing Address
Same as Street Address

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	1720143
		1306233572

Shipping Addresses

Same as Street Address

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
SCH190007-01	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NORTH NATCHITOCHES RURAL HEALTH CLINIC	3194 HWY 71	CAMPTI	LA	Terminated
SCH190007-02	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC Walk-In Clinic	740 Keyser Avenue	Natchitoches	LA	Terminated
SCH190007-03	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	Northwestern LA Cancer Center	211 Medical Drive	Natchitoches	LA	Terminated
SCH190007-04	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC OB/GYN	627 Bienville Circle	Natchitoches	LA	Terminated
SCH190007-05	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NATCHITOCHES REGIONAL MEDICAL CENTER -- Reflections - OP Psych	212 Medical Drive	Natchitoches	LA	Terminated
SCH190007-06	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC Walk-in Clinic - RHC	740 Keyser Ave.	Natchitoches	LA	Terminated
SCH190007-07	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - Orthopedics	601 KEYSER AVE	NATCHITOCHES	LA	Terminated
SCH190007-08	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - Urology	601 KEYSER AVE	NATCHITOCHES	LA	Terminated
SCH190007-09	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - Pulmonology	601 KEYSER AVE	NATCHITOCHES	LA	Terminated
SCH190007-10	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - GSA	601 KEYSER AVE	NATCHITOCHES	LA	Terminated
SCH190007-11	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - ENT	601 KEYSER AVE	NATCHITOCHES	LA	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	7/1/2019 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		4/15/2019 12:00:00 AM	4/16/2019 6:53 AM
Details	State	Update	Termination Request	Active	To Be Terminated	4/16/2019 6:53 AM
Terminations	Termination Date	Update	Termination Request		7/1/2019 12:00:00 AM	4/16/2019 6:53 AM
Terminations	Termination Effective Date	Update	Termination Request		4/15/2019 12:00:00 AM	4/16/2019 6:53 AM
Terminations	Termination Reason	Update	Termination Request		Business decision by the Covered Entity	4/16/2019 6:53 AM
Medicaid Billing	NPI: Number	Update	Recertification	1689676835	1306233572	9/4/2018 12:18 PM
Details	Last Recertification Date	Update	Recertification	11/16/2017 10:04:16 AM	9/4/2018 12:18:59 PM	9/4/2018 12:18 PM
Contacts	Primary Contact	Update	Change Request	Weatherford, Scott Director of Pharmacy NRMC 3182144359	Powell, Anne Director of Pharmacy Natchitoches Regional Medical Center 3182144359	4/13/2018 1:22 PM
Details	Last Recertification Date	Update	Recertification		11/16/2017 10:04:16 AM	11/16/2017 10:04 AM
Contacts	Primary Contact	Update	Recertification	Weatherford, Scott Director of Pharmacy 3182144359	Weatherford, Scott Director of Pharmacy NRMC 3182144359	11/16/2017 10:03 AM
Contacts	Authorizing Official	Update		Soileau, Damian K. CEO 3182144512	Soileau, Damian K. CEO Natchitoches Regional Medical Center 3182144512	11/16/2017 8:59 AM
Contacts	Signed By	Update		Soileau, Damian K. CEO 3182144512	Soileau, Damian K. CEO Natchitoches Regional Medical Center 3182144512	11/16/2017 8:59 AM
Addresses	Main Address	Insert			740 Keyser Avenue Natchitoches Regional Medical Center Walk-In Clinic Natchitoches, LA 71457	7/26/2017 12:55 PM
Contacts	Authorizing Official	Insert			Soileau, Damian K. CEO 3182144512	7/26/2017 12:55 PM
Contacts	Signed By	Insert			Soileau, Damian K. CEO 3182144512	7/26/2017 12:55 PM
Contacts	Primary Contact	Insert			Weatherford, Scott Director of Pharmacy 3182144359	7/26/2017 12:55 PM
Dates	Participating Approval Date	Update			8/8/2016 12:00:00 AM	8/8/2016 1:49 PM
Details	State	Update		Pending	Active	8/8/2016 1:49 PM
Dates	Start Date	Update			10/1/2016 12:00:00 AM	8/8/2016 1:49 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_71227	SCH190007-02	7/29/2016 11:07 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_71227	7/8/2016 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	7/8/2016 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			1720143	7/8/2016 2:34 PM
Medicaid Billing	Medicaid: State	Insert			LA	7/8/2016 2:34 PM
Medicaid Billing	NPI: Number	Insert			1689676835	7/8/2016 2:34 PM
Details	Last Recertification Date	Insert				7/8/2016 2:34 PM
Details	Grant Number	Insert				7/8/2016 2:34 PM
Details	340B ID	Insert				7/8/2016 2:34 PM
Details	Is Authorizing Official EHB Data	Insert				7/8/2016 2:34 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/8/2016 2:34 PM
Details	Medicare Provider Number	Insert			190007	7/8/2016 2:34 PM
Details	Entity Name	Insert			NATCHITOCHES REGIONAL MEDICAL CENTER	7/8/2016 2:34 PM
Details	Program Code	Insert			SCH	7/8/2016 2:34 PM
Details	Entity Subname	Insert			NRMC Walk-In Clinic	7/8/2016 2:34 PM
Dates	Participating Approval Date	Insert				7/8/2016 2:34 PM
Details	State	Insert			Pending	7/8/2016 2:34 PM
Dates	Registration Date	Insert			7/8/2016 12:00:00 AM	7/8/2016 2:34 PM
Dates	Signed By Date	Insert			7/8/2016 12:00:00 AM	7/8/2016 2:34 PM
Dates	Start Date	Insert				7/8/2016 2:34 PM
Terminations	Termination Comments	Insert				7/8/2016 2:34 PM
Terminations	Termination Date	Insert				7/8/2016 2:34 PM
Terminations	Termination Effective Date	Insert				7/8/2016 2:34 PM
Terminations	Termination Reason	Insert				7/8/2016 2:34 PM