Covered Entity Details

SCH190088-01 SPRINGHILL MEDICAL CENTER - AMENDED (Active) - information as of 5/6/2025 11:03:45 PM

Main Details

Name

SPRINGHILL MEDICAL CENTER - AMENDED

Subdivision Name

NORTH WEBSTER MEDICAL CLINIC - Rural Health Clinic

Type

Sole Community Hospital

Rural

Yes

340B ID

SCH190088-01

Medicare Provider Number

190088

Outpatient Facility Provider Number

193482

Additional Details

Current Program Status

Active

Registration Date

10/3/2017

Participating Start Date

1/1/2018

Participating Approval Date

10/5/2017

Last Recertification Date

8/16/2024

Contacts

Authorizing Official

Springhill Medical Center
Pete Johnson, CEO
(318) 539-1002

Primary Contact

Springhill Medical Center
Kristin Cole, CNO
(318) 539-1004

Addresses

Street Address

106 TRI-STATE DRIVE
SAREPTA, LA 71071-2826

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?
No

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
SCH190088-01	Child	SCH	SPRINGHILL MEDICAL CENTER - AMENDED	NORTH WEBSTER MEDICAL CLINIC - Rural Health Clinic	106 TRI-STATE DRIVE	SAREPTA	LA	Active
SCH190088-02	Child	SCH	SPRINGHILL MEDICAL CENTER - AMENDED	SMC/DOCTORS CLINIC - Rural Health Clinic	401 11TH NE	SPRINGHILL	LA	Active
SCH190088-03	Child	SCH	SPRINGHILL MEDICAL CENTER - AMENDED	Homer Medical Clinic - Rural Health Clinic	104 Morris Circle	Homer	LA	Terminated
SCH190088-04	Child	SCH	SPRINGHILL MEDICAL CENTER - AMENDED	Butler Abshire Medical Clinic Rural Health Clinic - Rural Health Clinic	900 Frances Drive	Haynesville	LA	Terminated
SCH190088-05	Child	SCH	SPRINGHILL MEDICAL CENTER - AMENDED	BRADLEY MEDICAL CLINIC - Rural Health Clinic	409 WOODRUFF STREET	BRADLEY	AR	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/18/2023 12:12:22 PM	8/16/2024 3:57:00 PM	8/16/2024 3:57 PM
Contacts	Authorizing Official	Update	Profile Change Request	Johnson, Pete CEO Springhill Medical Center 3185391001	Johnson, Pete CEO Springhill Medical Center 3185391002	2/28/2024 12:17 PM
Details	Last Recertification Date	Update	Recertification	9/1/2022 5:25:53 PM	8/18/2023 12:12:22 PM	8/18/2023 12:12 PM
Details	Last Recertification Date	Update	Recertification	8/31/2021 9:25:29 AM	9/1/2022 5:25:53 PM	9/1/2022 5:25 PM
Contacts	Primary Contact	Update	Change Request	Anderson, Edward CFO Springhill Medical Center 3185391056	Cole, Kristin CNO Springhill Medical Center 3185391004	1/28/2022 6:58 AM
Contacts	Primary Contact	Update	Change Request	Johnson, Peter Chief of Pharmacy & Ancillary Services Springhill Medical Services 3185391023	Anderson, Edward CFO Springhill Medical Center 3185391056	12/17/2021 2:07 PM
Contacts	Authorizing Official	Update	Change Request	Patronis, Michael G. CEO Springhill Medical Services, Inc 3185391001	Johnson, Pete CEO Springhill Medical Center 3185391001	10/8/2021 7:37 AM
Details	Last Recertification Date	Update	Recertification	8/26/2020 6:08:49 PM	8/31/2021 9:25:29 AM	8/31/2021 9:25 AM
Contacts	Primary Contact	Update	Change Request	Lahasky, Douglas Edward CFO Springhill Medical Services, Inc 3185391056	Johnson, Peter Chief of Pharmacy & Ancillary Services Springhill Medical Services 3185391023	10/30/2020 9:34 AM
Details	Last Recertification Date	Update	Recertification	8/19/2019 5:02:48 PM	8/26/2020 6:08:49 PM	8/26/2020 6:08 PM
Contacts	Primary Contact	Update	Change Request	Sanders, David L CFO Springhill Medical Center 3185391056	Lahasky, Douglas Edward CFO Springhill Medical Services, Inc 3185391056	6/18/2020 6:44 AM
Details	Last Recertification Date	Update	Recertification	8/29/2018 1:03:12 PM	8/19/2019 5:02:48 PM	8/19/2019 5:02 PM
Contacts	Authorizing Official	Update	AO Change Request	Sedminik, Vincent R CEO Springhill Medical Services, Inc 3185391001	Patronis, Michael G. CEO Springhill Medical Services, Inc 3185391001	3/1/2019 7:47 AM
Details	Last Recertification Date	Update	Recertification		8/29/2018 1:03:12 PM	8/29/2018 1:03 PM
Details	State	Update		Approved	Active	1/1/2018 12:00 AM
Contacts	Signed By	Insert	New Registration		Sedminik, Vincent R CEO Springhill Medical Services, Inc 3185391001	10/5/2017 3:41 PM
Details	340B ID	Update	New Registration		SCH190088-01	10/5/2017 3:41 PM
Details	Entity Subname	Update	New Registration	NORTH WEBSTER MEDICAL CLINIC	NORTH WEBSTER MEDICAL CLINIC - Rural Health Clinic	10/5/2017 3:41 PM
Dates	Participating Approval Date	Update	New Registration		10/5/2017 3:41:49 PM	10/5/2017 3:41 PM
Details	State	Update	New Registration	Pending	Approved	10/5/2017 3:41 PM
Dates	Signed By Date	Update	New Registration		10/3/2017 4:49:53 PM	10/5/2017 3:41 PM
Dates	Start Date	Update	New Registration		1/1/2018 12:00:00 AM	10/5/2017 3:41 PM
Addresses	Main Address	Insert	New Registration		106 TRI-STATE DRIVE SAREPTA, LA 71071-2826	10/3/2017 4:49 PM
Contacts	Primary Contact	Insert	New Registration		Sanders, David L CFO Springhill Medical Center 3185391056	10/3/2017 4:49 PM
Contacts	Authorizing Official	Insert	New Registration		Sedminik, Vincent R CEO Springhill Medical Services, Inc 3185391001	10/3/2017 4:49 PM
Details	Last Recertification Date	Insert	New Registration			10/3/2017 4:49 PM
Details	Grant Number	Insert	New Registration			10/3/2017 4:49 PM
Details	340B ID	Insert	New Registration			10/3/2017 4:49 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/3/2017 4:49 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/3/2017 4:49 PM
Details	Medicare Provider Number	Insert	New Registration		190088	10/3/2017 4:49 PM
Details	Entity Name	Insert	New Registration		SPRINGHILL MEDICAL CENTER - AMENDED	10/3/2017 4:49 PM
Details	Program Code	Insert	New Registration		SCH	10/3/2017 4:49 PM
Details	Entity Subname	Insert	New Registration		NORTH WEBSTER MEDICAL CLINIC	10/3/2017 4:49 PM
Dates	Participating Approval Date	Insert	New Registration			10/3/2017 4:49 PM
Details	State	Insert	New Registration		Pending	10/3/2017 4:49 PM
Dates	Registration Date	Insert	New Registration		10/3/2017 4:49:51 PM	10/3/2017 4:49 PM
Dates	Signed By Date	Insert	New Registration			10/3/2017 4:49 PM
Dates	Start Date	Insert	New Registration			10/3/2017 4:49 PM
Terminations	Termination Comments	Insert	New Registration			10/3/2017 4:49 PM
Terminations	Termination Date	Insert	New Registration			10/3/2017 4:49 PM
Terminations	Termination Effective Date	Insert	New Registration			10/3/2017 4:49 PM
Terminations	Termination Reason	Insert	New Registration			10/3/2017 4:49 PM