Covered Entity Details

DSH190274M OCHSNER MEDICAL CENTER - KENNER (Active) - information as of 5/6/2025 11:11:35 PM

Main Details

Name

OCHSNER MEDICAL CENTER - KENNER

Subdivision Name

CT Scan KNRH WA01 - RVPH CT SCAN

Type

Disproportionate Share Hospital

Rural

340B ID

DSH190274M

Medicare Provider Number

190274

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/17/2017

Participating Start Date

4/1/2017

Participating Approval Date

2/24/2017

Last Recertification Date

8/28/2024

Contacts

Authorizing Official

Ochsner Clinic Foundation
Courtney Garrett, CFO-Westbank & River Region
(504) 464-8690

Primary Contact

Ochsner Medical Center - Kenner
Kellee Brown, Pharmacy Manager
(504) 464-8041

Addresses

Street Address

1900 W. Airline Hwy
LA PLACE, LA 70068-5418

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
AZ	891466	1710097936
AR	167612105	1710097936
CA	1710097936	1710097936
NM	1710097936	1710097936
FL	000262100	1710097936
GA	618175380A	1710097936
IL	205432782001	1710097936
IN	300007899	1710097936
IA	1710097936	1710097936
KY	7100035200	1710097936
MI	1710097936	1710097936
MS	20186	1710097936
MO	010004311	1710097936
NY	3053803	1710097936
OK	200490880A	1710097936
PA	1026560920001	1710097936
TN	1388989	1710097936
TX	192313802	1710097936
WI	100022748	1710097936
LA	1704385	1710097936

Shipping Addresses

Shipping Address 1

Ochsner Medical Center Kenner Pharmacy
180 W Esplanade Ave
Kenner, LA 70065

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
DSH190274A	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	LSU Family Medicine KNRH WE02 - KNMH LSU FAMILY MED RESIDENTS	200 W. ESPLANADE AVENUE	KENNER	LA	Active
DSH190274B	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Oncology Services KNRH WE02 - Kenner Neuroendocrine	200 W. ESPLANADE AVENUE	KENNER	LA	Active
DSH190274C	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Infusion Center KNRH WE02 - KNMH CHEMOTHERAPY INFUSION	200 W ESPLANADE AVE	KENNER	LA	Active
DSH190274D	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Respiratory Therapy KNRH WA01 - RVPH RESPIRATORY THERAPY	1900 W. Airline Hwy	LA PLACE	LA	Active
DSH190274E	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Outpatient Rehab OTHK RD03 - RVPH REHAB OUTPATIENT SERVICES	506 Rue de Sante	LA PLACE	LA	Active
DSH190274F	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Mammography KNRH WA01 - RVPH MAMMOGRAPHY	1900 W. Airline Hwy	LA PLACE	LA	Active
DSH190274G	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Cardiology KNRH WA01 - RVPH CARDIOLOGY DIAGNOSTIC	1900 W. Airline Hwy	LA PLACE	LA	Active
DSH190274H	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Ultrasonography KNRH WA01 - RVPH ULTRASOUND	1900 W. Airline Hwy	LA PLACE	LA	Active
DSH190274J	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	OCHSNER MEDICAL COMPLEX RIVER PARIS / PHYSICAL THERAPY	1900 W. Airline Hwy	LA PLACE	LA	Terminated
DSH190274K	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	MRI KNRH WA01 - RVPH MRI	1900 W. Airline Hwy	LA PLACE	LA	Active
DSH190274L	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	X Ray KNRH WA01 - RVPH XRAY	1900 W. Airline Hwy	LA PLACE	LA	Active
DSH190274M	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	CT Scan KNRH WA01 - RVPH CT SCAN	1900 W. Airline Hwy	LA PLACE	LA	Active
DSH190274N	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Nuclear Medicine KNRH WA01 - RVPH BONE MINERAL DENSITY	1900 W. Airline Hwy	LA PLACE	LA	Active
DSH190274P	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Laboratory KNRH WA01 - RVPH LABORATORY	1900 W. Airline Highway	LA PLACE	LA	Active
DSH190274Q	Child	DSH	OCHSNER MEDICAL CENTER - KENNER	Emergency Room KNRH WA01 - RVPH EMERGENCY DEPARTMENT	1900 W. Airline Hwy	LA PLACE	LA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/29/2023 3:18:30 PM	8/28/2024 6:45:25 AM	8/28/2024 6:45 AM
Details	Entity Subname	Update	Recertification	CT Scan KNRH WA01 - River Parishes Medical Complex CT Scan	CT Scan KNRH WA01 - RVPH CT SCAN	8/28/2024 6:45 AM
Details	Last Recertification Date	Update	Recertification	9/7/2022 12:59:12 PM	8/29/2023 3:18:30 PM	8/29/2023 3:18 PM
Contacts	Primary Contact	Update	PC Change Request	Leung, Barries Director of Pharmacy Ochsner Medical Center Kenner 5044648042	Brown, Kellee Pharmacy Manager Ochsner Medical Center - Kenner 5044648041	8/3/2023 4:16 PM
Contacts	Authorizing Official	Update	AO Change Request	Alleman, Tara E CFO St Charles Parish Hospital 9857853726	Garrett, Courtney CFO-Westbank & River Region Ochsner Clinic Foundation 5044648690	7/19/2023 1:04 PM
Medicaid Billing	Medicaid: Number	Delete	Group Change Request	1900274 (NC)		6/19/2023 9:48 AM
Medicaid Billing	NPI: Number	Delete	Group Change Request	1710097936 (NC)		6/19/2023 9:48 AM
Details	Last Recertification Date	Update	Recertification	8/31/2021 3:33:05 PM	9/7/2022 12:59:12 PM	9/7/2022 12:59 PM
Details	Last Recertification Date	Update	Recertification	9/14/2020 3:56:42 PM	8/31/2021 3:33:05 PM	8/31/2021 3:33 PM
Medicaid Billing	Medicaid: State	Update	Recertification	CT	NM	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		FL	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		MO	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		WI	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		PA	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		TN	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		AR	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		LA	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		CA	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		NM	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		IA	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		MI	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		NC	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		OK	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		MS	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		IL	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		IN	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		NY	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		GA	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		KY	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1710097936	9/14/2020 3:56 PM
Medicaid Billing	NPI: State	Insert	Recertification		AZ	9/14/2020 3:56 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1710097936 ( )		9/14/2020 3:56 PM
Details	Last Recertification Date	Update	Recertification	9/16/2019 3:17:55 PM	9/14/2020 3:56:42 PM	9/14/2020 3:56 PM
Details	Entity Subname	Update	Recertification	CT Scan KNRH RD01 - River Parishes Medical Complex CT Scan	CT Scan KNRH WA01 - River Parishes Medical Complex CT Scan	9/14/2020 3:56 PM
Contacts	Authorizing Official	Update	AO Change Request	Eckert, Mark CFO Ochsner Health Sysem 5044648059	Alleman, Tara E CFO St Charles Parish Hospital 9857853726	8/7/2020 12:39 PM
Addresses	Billing Address	Update	Recertification	Ochsner Medical Center Kenner Pharmacy 180 W Esplanade Ave Kenner, LA 70065	Ochsner Clinic Foundation - Accounts Payable 1201 Dickory Ave New Orleans, LA 70123	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		891466	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		AZ	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		167612105	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		AR	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1710097936	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		CA	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1710097936	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		CT	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		000262100	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		FL	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		618175380A	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		GA	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		205432782001	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		IL	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		300007899	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		IN	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1710097936	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		IA	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		7100035200	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		KY	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1710097936	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		MI	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		20186	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		MS	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		010004311	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		MO	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		3053803	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		NY	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1900274	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		NC	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		200490880A	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		OK	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1026560920001	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		PA	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		1388989	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TN	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		192313802	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TX	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		100022748	9/16/2019 3:17 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		WI	9/16/2019 3:17 PM
Details	Last Recertification Date	Update	Recertification	9/5/2018 3:07:12 PM	9/16/2019 3:17:55 PM	9/16/2019 3:17 PM
Details	Entity Subname	Update	Recertification	OCHSNER MEDICAL COMPLEX RIVER PARIS / CT SCAN	CT Scan KNRH RD01 - River Parishes Medical Complex CT Scan	9/16/2019 3:17 PM
Details	Last Recertification Date	Update	Recertification	11/9/2017 7:43:07 AM	9/5/2018 3:07:12 PM	9/5/2018 3:07 PM
Addresses	Main Address	Update	Recertification	500 RUE DE SANTE LA PLACE, LA 70068-5418	1900 W. Airline Hwy LA PLACE, LA 70068-5418	11/9/2017 7:43 AM
Details	Last Recertification Date	Update	Recertification		11/9/2017 7:43:07 AM	11/9/2017 7:43 AM
Details	Entity Name	Update	Recertification	OCHSNER MEDICAL CENTER - KENNER LLC	OCHSNER MEDICAL CENTER - KENNER	11/9/2017 7:42 AM
Contacts	Primary Contact	Update		Leung, Barries Director of Pharmacy 5044648042	Leung, Barries Director of Pharmacy Ochsner Medical Center Kenner 5044648042	10/12/2017 10:55 AM
Contacts	Authorizing Official	Update		Eckert, Mark CFO 5044648059	Eckert, Mark CFO Ochsner Health Sysem 5044648059	10/4/2017 4:46 PM
Contacts	Signed By	Update		Eckert, Mark CFO 5044648059	Eckert, Mark CFO Ochsner Health Sysem 5044648059	10/4/2017 4:46 PM
Contacts	Authorizing Official	Insert			Eckert, Mark CFO 5044648059	2/24/2017 4:23 PM
Contacts	Signed By	Insert			Eckert, Mark CFO 5044648059	2/24/2017 4:23 PM
Contacts	Primary Contact	Insert			Leung, Barries Director of Pharmacy 5044648042	2/24/2017 4:23 PM
Addresses	Main Address	Insert			500 RUE DE SANTE LA PLACE, LA 70068-5418	2/24/2017 4:23 PM
Addresses	Billing Address	Insert			Ochsner Medical Center Kenner Pharmacy 180 W Esplanade Ave Kenner, LA 70065	2/24/2017 4:23 PM
Addresses	Shipping Address	Insert			Ochsner Medical Center Kenner Pharmacy 180 W Esplanade Ave Kenner, LA 70065	2/24/2017 4:23 PM
Dates	Participating Approval Date	Update			2/24/2017 12:00:00 AM	2/24/2017 4:22 PM
Details	State	Update		Pending	Active	2/24/2017 4:22 PM
Dates	Start Date	Update			4/1/2017 12:00:00 AM	2/24/2017 4:22 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_75354	DSH190274M	2/7/2017 12:53 PM
Details	Entity Subname	Update		OCHSNER MEDICAL COMPLEX RIVER PARIS / CT SCAN RPH	OCHSNER MEDICAL COMPLEX RIVER PARIS / CT SCAN	2/7/2017 12:53 PM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_75354	1/17/2017 5:08 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	1/17/2017 5:08 PM
Medicaid Billing	Medicaid: Number	Insert			1704385	1/17/2017 5:08 PM
Medicaid Billing	Medicaid: State	Insert			LA	1/17/2017 5:08 PM
Medicaid Billing	NPI: Number	Insert			1710097936	1/17/2017 5:08 PM
Details	Last Recertification Date	Insert				1/17/2017 5:08 PM
Details	Grant Number	Insert				1/17/2017 5:08 PM
Details	340B ID	Insert				1/17/2017 5:08 PM
Details	Is Authorizing Official EHB Data	Insert				1/17/2017 5:08 PM
Dates	Last Date That 340B Drugs Purchased	Insert				1/17/2017 5:08 PM
Details	Medicare Provider Number	Insert			190274	1/17/2017 5:08 PM
Details	Entity Name	Insert			OCHSNER MEDICAL CENTER - KENNER LLC	1/17/2017 5:08 PM
Details	Program Code	Insert			DSH	1/17/2017 5:08 PM
Details	Entity Subname	Insert			OCHSNER MEDICAL COMPLEX RIVER PARIS / CT SCAN RPH	1/17/2017 5:08 PM
Dates	Participating Approval Date	Insert				1/17/2017 5:08 PM
Details	State	Insert			Pending	1/17/2017 5:08 PM
Dates	Registration Date	Insert			1/17/2017 12:00:00 AM	1/17/2017 5:08 PM
Dates	Signed By Date	Insert			1/17/2017 12:00:00 AM	1/17/2017 5:08 PM
Dates	Start Date	Insert				1/17/2017 5:08 PM
Terminations	Termination Comments	Insert				1/17/2017 5:08 PM
Terminations	Termination Date	Insert				1/17/2017 5:08 PM
Terminations	Termination Effective Date	Insert				1/17/2017 5:08 PM
Terminations	Termination Reason	Insert				1/17/2017 5:08 PM