Covered Entity Details

DSH190045N ST. TAMMANY PARISH HOSPITAL (Active) - information as of 5/20/2025 12:55:07 AM

Main Details

Name

ST. TAMMANY PARISH HOSPITAL

Subdivision Name

BONE AND JOINT CLINIC AT ST TAMMANY - Outpatient Orthopedic Clinic

Type

Disproportionate Share Hospital

Rural

340B ID

DSH190045N

Medicare Provider Number

190045

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/2/2018

Participating Start Date

10/1/2018

Participating Approval Date

7/19/2018

Last Recertification Date

8/14/2024

Contacts

Authorizing Official

St. Tammany Parish Hospital
Sandra DiPietro, Senior Vice President/Chief Financial Officer
(985) 898-4583

Primary Contact

St. Tammany Parish Hospital
Lesleigh Hall, AVP Legal Affairs
(985) 871-5830

Addresses

Street Address

71211 HIGHWAY 21
STE A
COVINGTON, LA 70433-7121

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	2353284,1720259	1598798597

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
DSH190045C	Child	DSH	ST. TAMMANY PARISH HOSPITAL	ST. TAMMANY PHYSICIAN NETWORK MANDEVILLE	201 St. Ann Street Suite B	MANDEVILLE	LA	Active
DSH190045E	Child	DSH	ST. TAMMANY PARISH HOSPITAL	WOMEN'S HEALTH SERVICES	301 N. Hwy 190	Covington	LA	Active
DSH190045F	Child	DSH	ST. TAMMANY PARISH HOSPITAL	PAUL D. CORDES OUTPATIENT PAVILION	16300 HWY 1085	COVINGTON	LA	Active
DSH190045H	Child	DSH	ST. TAMMANY PARISH HOSPITAL	Mandeville Diagnostic Center	201 St. Ann Drive	Mandeville	LA	Terminated
DSH190045J	Child	DSH	ST. TAMMANY PARISH HOSPITAL	ST TAMMANY PARISH HOSPITAL OFFSITE - Offsite Campus Emergency Department	2929 HIGHWAY 190	MANDEVILLE	LA	Active
DSH190045K	Child	DSH	ST. TAMMANY PARISH HOSPITAL	NORTHLAKE SURGICAL ASSOCIATES AT ST - General Surgery Clinic	606 W 11TH AVE	COVINGTON	LA	Active
DSH190045L	Child	DSH	ST. TAMMANY PARISH HOSPITAL	COVINGTON CARDIOVASCULAR CARE AT ST - Cardiology clinic	1006 S HARRISON ST	COVINGTON	LA	Active
DSH190045M	Child	DSH	ST. TAMMANY PARISH HOSPITAL	ST TAMMANY PHYSICIANS NETWORK FOLSOM	82525 HIGHWAY 25	FOLSOM	LA	Active
DSH190045N	Child	DSH	ST. TAMMANY PARISH HOSPITAL	BONE AND JOINT CLINIC AT ST TAMMANY - Outpatient Orthopedic Clinic	71211 HIGHWAY 21	COVINGTON	LA	Active
DSH190045P	Child	DSH	ST. TAMMANY PARISH HOSPITAL	Outpatient Rehabilitation Services - Outpatient Rehab	1 N. Azalea Drive	Covington	LA	Active
DSH190045Q	Child	DSH	ST. TAMMANY PARISH HOSPITAL	ST TAMMANY PHYSICIANS NETWORK COVIN - primary care	80 GARDENIA DR	COVINGTON	LA	Active
DSH190045R	Child	DSH	ST. TAMMANY PARISH HOSPITAL	St. Tammany Physicians Network - Madisonville	1520 HIGHWAY 22 W	MADISONVILLE	LA	Active
DSH190045S	Child	DSH	ST. TAMMANY PARISH HOSPITAL	St. Tammany Hospital Home Health - Home Health	101 Ashland Way	Covington	LA	Active
DSH190045T	Child	DSH	ST. TAMMANY PARISH HOSPITAL	St. Tammany Hospital Hospice - Hospice	101 Ashland Way	Covington	LA	Active
DSH190045U	Child	DSH	ST. TAMMANY PARISH HOSPITAL	St. Tammany Pediatrics and Express Care for Kids - Pediatrics	3663 US Highway 190	Mandeville	LA	Active
DSH190045V	Child	DSH	ST. TAMMANY PARISH HOSPITAL	Palliative Medicine and Supportive Care - Palliative and Supportive Care	1010 S. Polk Street	Covington	LA	Active
DSH190045W	Child	DSH	ST. TAMMANY PARISH HOSPITAL	St. Tammany Health System Surgery Center - Outpatient Surgery	16282 Highway 1085	Covington	LA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/14/2023 9:02:48 AM	8/14/2024 9:10:56 AM	8/14/2024 9:10 AM
Details	Last Recertification Date	Update	Recertification	8/30/2022 9:15:26 AM	8/14/2023 9:02:48 AM	8/14/2023 9:02 AM
Details	Last Recertification Date	Update	Recertification	8/18/2021 9:05:30 AM	8/30/2022 9:15:26 AM	8/30/2022 9:15 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1598193625 (LA)		11/1/2021 1:54 PM
Details	Last Recertification Date	Update	Recertification	9/2/2020 9:02:17 AM	8/18/2021 9:05:30 AM	8/18/2021 9:05 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1343943 (LA)		11/20/2020 11:22 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1388378 (LA)		11/20/2020 11:22 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	2108905 (LA)		11/20/2020 11:22 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	2434411 (LA)		11/20/2020 11:22 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1417042706 (LA)		11/20/2020 11:22 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1659466845 (LA)		11/20/2020 11:22 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1760706782 (LA)		11/20/2020 11:22 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1962723049 (LA)		11/20/2020 11:22 AM
Medicaid Billing	NPI: State	Update	Recertification		LA	9/2/2020 9:02 AM
Medicaid Billing	NPI: State	Update	Recertification		LA	9/2/2020 9:02 AM
Medicaid Billing	NPI: State	Update	Recertification		LA	9/2/2020 9:02 AM
Medicaid Billing	NPI: State	Update	Recertification		LA	9/2/2020 9:02 AM
Medicaid Billing	NPI: State	Update	Recertification		LA	9/2/2020 9:02 AM
Medicaid Billing	NPI: State	Update	Recertification		LA	9/2/2020 9:02 AM
Details	Last Recertification Date	Update	Recertification	8/20/2019 6:22:38 PM	9/2/2020 9:02:17 AM	9/2/2020 9:02 AM
Contacts	Primary Contact	Update	Profile Change Request	Hall, Lesleigh Staff Attorney St. Tammany Parish Hospital 9858715830	Hall, Lesleigh AVP Legal Affairs St. Tammany Parish Hospital 9858715830	9/1/2020 12:11 PM
Details	Last Recertification Date	Update	Recertification		8/20/2019 6:22:38 PM	8/20/2019 6:22 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		2353284	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		LA	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1343943	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		LA	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1388378	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		LA	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		2108905	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		LA	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		2434411	10/30/2018 3:55 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		LA	10/30/2018 3:55 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1598193625	10/30/2018 3:55 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1417042706	10/30/2018 3:55 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1659466845	10/30/2018 3:55 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1760706782	10/30/2018 3:55 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1962723049	10/30/2018 3:55 PM
Details	State	Update		Approved	Active	10/1/2018 12:05 AM
Contacts	Signed By	Insert	New Registration		DiPietro, Sandra Senior Vice President/Chief Financial Officer St. Tammany Parish Hospital 9858984583	7/19/2018 8:04 AM
Details	340B ID	Update	New Registration		DSH190045N	7/19/2018 8:04 AM
Details	Entity Subname	Update	New Registration	BONE AND JOINT CLINIC AT ST TAMMANY	BONE AND JOINT CLINIC AT ST TAMMANY - Outpatient Orthopedic Clinic	7/19/2018 8:04 AM
Dates	Participating Approval Date	Update	New Registration		7/19/2018 8:04:13 AM	7/19/2018 8:04 AM
Details	State	Update	New Registration	Pending	Approved	7/19/2018 8:04 AM
Dates	Signed By Date	Update	New Registration		7/2/2018 2:40:08 PM	7/19/2018 8:04 AM
Dates	Start Date	Update	New Registration		10/1/2018 12:00:00 AM	7/19/2018 8:04 AM
Addresses	Main Address	Insert	New Registration		71211 HIGHWAY 21 STE A COVINGTON, LA 70433-7121	7/2/2018 1:14 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/2/2018 1:14 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1720259	7/2/2018 1:14 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		LA	7/2/2018 1:14 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1598798597	7/2/2018 1:14 PM
Contacts	Primary Contact	Insert	New Registration		Hall, Lesleigh Staff Attorney St. Tammany Parish Hospital 9858715830	7/2/2018 1:14 PM
Contacts	Authorizing Official	Insert	New Registration		DiPietro, Sandra Senior Vice President/Chief Financial Officer St. Tammany Parish Hospital 9858984583	7/2/2018 1:14 PM
Details	Last Recertification Date	Insert	New Registration			7/2/2018 1:14 PM
Details	Grant Number	Insert	New Registration			7/2/2018 1:14 PM
Details	340B ID	Insert	New Registration			7/2/2018 1:14 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/2/2018 1:14 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/2/2018 1:14 PM
Details	Medicare Provider Number	Insert	New Registration		190045	7/2/2018 1:14 PM
Details	Entity Name	Insert	New Registration		ST. TAMMANY PARISH HOSPITAL	7/2/2018 1:14 PM
Details	Program Code	Insert	New Registration		DSH	7/2/2018 1:14 PM
Details	Entity Subname	Insert	New Registration		BONE AND JOINT CLINIC AT ST TAMMANY	7/2/2018 1:14 PM
Dates	Participating Approval Date	Insert	New Registration			7/2/2018 1:14 PM
Details	State	Insert	New Registration		Pending	7/2/2018 1:14 PM
Dates	Registration Date	Insert	New Registration		7/2/2018 1:14:09 PM	7/2/2018 1:14 PM
Dates	Signed By Date	Insert	New Registration			7/2/2018 1:14 PM
Dates	Start Date	Insert	New Registration			7/2/2018 1:14 PM
Terminations	Termination Comments	Insert	New Registration			7/2/2018 1:14 PM
Terminations	Termination Date	Insert	New Registration			7/2/2018 1:14 PM
Terminations	Termination Effective Date	Insert	New Registration			7/2/2018 1:14 PM
Terminations	Termination Reason	Insert	New Registration			7/2/2018 1:14 PM