Covered Entity Details

DSH190015T North Oaks Medical Center LLC (Active) - information as of 6/27/2025 12:34:44 AM

Main Details

Name

North Oaks Medical Center LLC

Subdivision Name

MAGNOLIA OB/GYN - OB/GYN

Type

Disproportionate Share Hospital

Rural

340B ID

DSH190015T

Medicare Provider Number

190015

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/11/2019

Participating Start Date

4/1/2019

Participating Approval Date

1/24/2019

Last Recertification Date

8/16/2024

Contacts

Authorizing Official

North Oaks Health System
Mark T Anderson, CFO
(985) 230-6602

Primary Contact

North Oaks Medical Center
Frances H. Pearson, PHARMACY DIRECTOR
(985) 230-6313

Addresses

Street Address

15813 PAUL VEGA MD DRIVE
SUITE 200
HAMMOND, LA 70403-1431

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	1720267	1144227539
MS	00020364	1144227539

Shipping Addresses

Shipping Address 1

North Oaks Medical Center Materials Management
15790 Paul Vega MD Dr.
Hammond, LA 70403

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
DSH190015A	Child	DSH	North Oaks Medical Center LLC	DBA NORTH OAKS MEDICAL CENTER	INFUSION UNIT	HAMMOND	LA	Active
DSH190015AA	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS PULMONOLOGY - Pulmonology	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015AB	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS ENDOCRINOLOGY - Endocrinology	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015AC	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS CARDIOLOGY - Cardiology Clinic	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015AD	Child	DSH	North Oaks Medical Center LLC	MRI-ODC - Radiology	15837 Paul Vega Md Drive	Hammond	LA	Active
DSH190015AE	Child	DSH	North Oaks Medical Center LLC	CT Scan-ODC - Radiology	15837 Paul Vega MD Drive	Hammond	LA	Active
DSH190015AF	Child	DSH	North Oaks Medical Center LLC	Radiology/Diagnostics - Radiology	15837 Paul Vega Md Drive	Hammond	LA	Active
DSH190015AG	Child	DSH	North Oaks Medical Center LLC	Mammography-ODC - Radiology	15837 Paul Vega MD Drive	Hammond	LA	Active
DSH190015AH	Child	DSH	North Oaks Medical Center LLC	Nuclear Medicine-ODC - Radiology	15837 Paul Vega MD Drive	Hammond	LA	Active
DSH190015AJ	Child	DSH	North Oaks Medical Center LLC	Ultrasound-ODC - Radiology	15837 Paul Vega MD Drive	Hammond	LA	Active
DSH190015AK	Child	DSH	North Oaks Medical Center LLC	Interventional Radiology-ODC - Radiology	15837 Paul Vega Md Drive	Hammond	LA	Active
DSH190015AL	Child	DSH	North Oaks Medical Center LLC	Livingston Parish Medical Complex-LMC Mammography - Radiology	17199 Spring Ranch Road	Livingston	LA	Active
DSH190015AM	Child	DSH	North Oaks Medical Center LLC	Livingston Parish Medical Complex-LMC MRI - Radiology	17199 Spring Ranch Road	Livingston	LA	Active
DSH190015AN	Child	DSH	North Oaks Medical Center LLC	Livingston Parish Medical Complex-LMC Ultrasound - Radiology	17199 Spring Ranch Road	Livingston	LA	Active
DSH190015AP	Child	DSH	North Oaks Medical Center LLC	Livingston Parish Medical Complex-LMC Cat Scan - Radiology	17199 Spring Ranch Road	Livingston	LA	Active
DSH190015AQ	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS HEMOTOLOGY/ONCOLOGY CLIN - hematology/oncology	15837 PAUL VEGA MD DR	HAMMOND	LA	Active
DSH190015AR	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS MEDICAL CENTER LLC - Outpatient would care	2101 ROBIN AVE	HAMMOND	LA	Active
DSH190015AS	Child	DSH	North Oaks Medical Center LLC	North Oaks Cardiovascular-Thoracic Surgery - Cardiovascular-Thoracic clinic	15813 Paul Vega MD Drive	Hammond	LA	Active
DSH190015AT	Child	DSH	North Oaks Medical Center LLC	North Oaks Pediatric Specialty Clinic - Pediatric Specialty Clinic	15742 Medical Arts Drive	Hammond	LA	ToBeTerminated
DSH190015B	Child	DSH	North Oaks Medical Center LLC	Outpatient Diagnostic Center-lab	15837 Paul Vega MD Drive	Hammond	LA	Active
DSH190015C	Child	DSH	North Oaks Medical Center LLC	Livingston Parish Medical Complex-Nuclear Medicine	17199 Spring Ranch Road	Livingston	LA	ToBeTerminated
DSH190015D	Child	DSH	North Oaks Medical Center LLC	Livingston Parish Medical Complex-Lab	17199 Spring Ranch Road	Livingston	LA	Active
DSH190015E	Child	DSH	North Oaks Medical Center LLC	Livingston Parish Medical Complex-Cardiology	17199 Spring Ranch Road	Livingston	LA	ToBeTerminated
DSH190015F	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS LIVINGSTON PARISH MEDICAL-Diagnostic Radiology	17199 SPRING RANCH ROAD	LIVINGSTON	LA	Active
DSH190015G	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS SURGERY CENTER-Recovery Room	42144 VETERANS AVENUE	HAMMOND	LA	Active
DSH190015H	Child	DSH	North Oaks Medical Center LLC	North Oaks Surgery Center	42144 Veterans Ave	HAMMOND	LA	Terminated
DSH190015J	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS SHOCK TRAUMA CLINIC - Trauma Clinic	15770 PAUL VEGA MD DR	HAMMOND	LA	Active
DSH190015K	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS NEUROLOGY - Neurology	15784 Medical Arts Dr.	HAMMOND	LA	Active
DSH190015L	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS INFECTIOUS DISEASE CLINI - Infectious Disease	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015M	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS PERINATOLOGY CLINIC - Perinatology	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015N	Child	DSH	North Oaks Medical Center LLC	NORTHSHORE INTERNAL MEDICINE ASOCIA - Internal Medicine	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015P	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS PAIN MANAGEMENT - Pain Management	15770 PAUL VEGA MD DR	HAMMOND	LA	Active
DSH190015Q	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS FAMILY MEDICINE CLINIC M - Family Medicine	15770 PAUL VEGA MD DR	HAMMOND	LA	Active
DSH190015R	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS NEUROSURGERY CLINIC - Neurosurgery	15784 Medical Arts Dr.	HAMMOND	LA	Active
DSH190015S	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS ORTHOPEDIC SPECIALTY CEN - Orthopedics	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015T	Child	DSH	North Oaks Medical Center LLC	MAGNOLIA OB/GYN - OB/GYN	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015U	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS EYE CARE CLINIC - Ophthalmology	15770 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015V	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS PRIMARY CARE CLINIC - Primary Care	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015W	Child	DSH	North Oaks Medical Center LLC	PLAZA ORTHOPEDICS - Orthopedics	15770 PAUL VEGA MD DR	HAMMOND	LA	Terminated
DSH190015X	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS ENT & ALLERGY CLINIC - ENT and Allergy	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015Y	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS RHEUMATOLOGY CLINIC - Rheumatology	15813 PAUL VEGA MD DRIVE	HAMMOND	LA	Active
DSH190015Z	Child	DSH	North Oaks Medical Center LLC	NORTH OAKS SURGICAL ASSOCIATES - Surgery	15770 PAUL VEGA MD DR	HAMMOND	LA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/14/2023 2:12:06 PM	8/16/2024 12:26:29 PM	8/16/2024 12:26 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	20364 (MS)		4/10/2024 10:22 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	4/10/2024 10:22 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		00020364	4/10/2024 10:22 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		MS	4/10/2024 10:22 AM
Details	Last Recertification Date	Update	Recertification	8/26/2022 9:17:53 AM	8/14/2023 2:12:06 PM	8/14/2023 2:12 PM
Details	Last Recertification Date	Update	Recertification	8/16/2021 2:31:47 PM	8/26/2022 9:17:53 AM	8/26/2022 9:17 AM
Details	Last Recertification Date	Update	Recertification	8/18/2020 12:31:50 PM	8/16/2021 2:31:47 PM	8/16/2021 2:31 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1144227539	8/18/2020 12:31 PM
Medicaid Billing	NPI: State	Insert	Recertification		LA	8/18/2020 12:31 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1144227539	8/18/2020 12:31 PM
Medicaid Billing	NPI: State	Insert	Recertification		MS	8/18/2020 12:31 PM
Details	Last Recertification Date	Update	Recertification	8/23/2019 2:33:09 PM	8/18/2020 12:31:50 PM	8/18/2020 12:31 PM
Details	Last Recertification Date	Update	Recertification		8/23/2019 2:33:09 PM	8/23/2019 2:33 PM
Details	State	Update		Approved	Active	4/1/2019 12:05 AM
Addresses	Shipping Address	Insert	Change Request		North Oaks Medical Center Materials Management 15790 Paul Vega MD Dr. Hammond, LA 70403	2/20/2019 8:37 AM
Contacts	Signed By	Insert	New Registration		Anderson, Mark T CFO North Oaks Health System 9852306602	1/24/2019 12:37 PM
Details	340B ID	Update	New Registration		DSH190015T	1/24/2019 12:37 PM
Details	Entity Name	Update	New Registration	NORTH OAKS MEDICAL CENTER	North Oaks Medical Center LLC	1/24/2019 12:37 PM
Details	Entity Subname	Update	New Registration	MAGNOLIA OB/GYN	MAGNOLIA OB/GYN - OB/GYN	1/24/2019 12:37 PM
Dates	Participating Approval Date	Update	New Registration		1/24/2019 12:37:01 PM	1/24/2019 12:37 PM
Details	State	Update	New Registration	Pending	Approved	1/24/2019 12:37 PM
Dates	Signed By Date	Update	New Registration		1/13/2019 4:45:21 PM	1/24/2019 12:37 PM
Dates	Start Date	Update	New Registration		4/1/2019 12:00:00 AM	1/24/2019 12:37 PM
Addresses	Main Address	Insert	New Registration		15813 PAUL VEGA MD DRIVE SUITE 200 HAMMOND, LA 70403-1431	1/11/2019 2:22 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/11/2019 2:22 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1720267	1/11/2019 2:22 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		LA	1/11/2019 2:22 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/11/2019 2:22 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		20364	1/11/2019 2:22 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		MS	1/11/2019 2:22 PM
Contacts	Primary Contact	Insert	New Registration		Pearson, Frances H. PHARMACY DIRECTOR North Oaks Medical Center 9852306313	1/11/2019 2:22 PM
Contacts	Authorizing Official	Insert	New Registration		Anderson, Mark T CFO North Oaks Health System 9852306602	1/11/2019 2:22 PM
Details	Last Recertification Date	Insert	New Registration			1/11/2019 2:22 PM
Details	Grant Number	Insert	New Registration			1/11/2019 2:22 PM
Details	340B ID	Insert	New Registration			1/11/2019 2:22 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/11/2019 2:22 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/11/2019 2:22 PM
Details	Medicare Provider Number	Insert	New Registration		190015	1/11/2019 2:22 PM
Details	Entity Name	Insert	New Registration		NORTH OAKS MEDICAL CENTER	1/11/2019 2:22 PM
Details	Program Code	Insert	New Registration		DSH	1/11/2019 2:22 PM
Details	Entity Subname	Insert	New Registration		MAGNOLIA OB/GYN	1/11/2019 2:22 PM
Dates	Participating Approval Date	Insert	New Registration			1/11/2019 2:22 PM
Details	State	Insert	New Registration		Pending	1/11/2019 2:22 PM
Dates	Registration Date	Insert	New Registration		1/11/2019 2:22:33 PM	1/11/2019 2:22 PM
Dates	Signed By Date	Insert	New Registration			1/11/2019 2:22 PM
Dates	Start Date	Insert	New Registration			1/11/2019 2:22 PM
Terminations	Termination Comments	Insert	New Registration			1/11/2019 2:22 PM
Terminations	Termination Date	Insert	New Registration			1/11/2019 2:22 PM
Terminations	Termination Effective Date	Insert	New Registration			1/11/2019 2:22 PM
Terminations	Termination Reason	Insert	New Registration			1/11/2019 2:22 PM