Covered Entity Details

DSH190025G SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER (Active) - information as of 5/16/2025 11:22:08 PM

Main Details

Name

SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER

Subdivision Name

Cancer Center - Oncology

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH190025G

Medicare Provider Number

190025

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/14/2022

Participating Start Date

7/1/2022

Participating Approval Date

4/27/2022

Last Recertification Date

8/23/2024

Contacts

Authorizing Official

Savoy Medical Center
Brian Denton, CEO
(337) 468-0350

Primary Contact

Savoy Medical Center
John Pitre, Pharmacy Director
(337) 468-0149

Addresses

Street Address

803 Poinciana
Mamou, LA 70554

Billing Address

SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER
801 POINCIANA AVENUE
MAMOU, LA 70554

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	1766062	1255667002

Shipping Addresses

Shipping Address 1

SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER
801 POINCIANA AVENUE
MAMOU, LA 70554

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
DSH190025A	Child	DSH	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A ELTON RURAL HEALTH CLINIC	907 MAIN STREET	ELTON	LA	Active
DSH190025B	Child	DSH	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER	SAVOY FAMILY CARE	102 SOUTH 2ND STREET	EUNICE	LA	Active
DSH190025C	Child	DSH	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER	NEW HORIZONS / Psych	1610 7TH ST	MAMOU	LA	Active
DSH190025D	Child	DSH	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER	Mamou Family Care - Family Medicine	704 Poinciana Avenue	Mamou	LA	Active
DSH190025E	Child	DSH	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER	Ville Platte Family Care - Family Medicine	1013 W. Lincoln Road	Ville Platte	LA	Active
DSH190025F	Child	DSH	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER	Basile Rural Health Clinic - RHC	1431 N. Fusilier Avenue	Basile	LA	Active
DSH190025G	Child	DSH	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER	Cancer Center - Oncology	803 Poinciana	Mamou	LA	Active
DSH190025H	Child	DSH	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER	Oberlin Family Care - Primary Care	616 Court St	Oberlin	LA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	AO Change Request	Burge, Eugene CEO Savoy Medical Center 3374680355	Denton, Brian CEO Savoy Medical Center 3374680350	12/19/2024 11:34 AM
Details	Last Recertification Date	Update	Recertification	8/21/2023 12:25:06 PM	8/23/2024 11:31:41 AM	8/23/2024 11:31 AM
Addresses	Billing Address	Insert	Group Change Request		SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER 801 POINCIANA AVENUE MAMOU, LA 70554	7/18/2024 12:40 PM
Addresses	Shipping Address	Insert	Group Change Request		SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER 801 POINCIANA AVENUE MAMOU, LA 70554	7/18/2024 12:40 PM
Contacts	Authorizing Official	Update	AO Change Request	Soileau, Michelle CFO Savoy Medical Center 3374680154	Burge, Eugene CEO Savoy Medical Center 3374680355	6/11/2024 8:05 AM
Contacts	Authorizing Official	Update	AO Change Request	ARMENTOR, LANCE CEO SAVOY MEDICAL MANAGEMENT GROUP, INC. 3374680350	Soileau, Michelle CFO Savoy Medical Center 3374680154	3/18/2024 10:56 AM
Details	Last Recertification Date	Update	Recertification	8/30/2022 1:16:59 PM	8/21/2023 12:25:06 PM	8/21/2023 12:25 PM
Details	Last Recertification Date	Update	Recertification		8/30/2022 1:16:59 PM	8/30/2022 1:16 PM
Details	State	Update		Approved	Active	7/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		ARMENTOR, LANCE CEO SAVOY MEDICAL MANAGEMENT GROUP, INC. 3374680350	4/27/2022 6:42 AM
Details	340B ID	Update	New Registration		DSH190025G	4/27/2022 6:42 AM
Details	Entity Name	Update	New Registration	SAVOY MEDICAL MANAGEMENT GROUP INC.	SAVOY MEDICAL MANAGEMENT GROUP, INC. D/B/A SAVOY MEDICAL CENTER	4/27/2022 6:42 AM
Details	Entity Subname	Update	New Registration	Cancer Center	Cancer Center - Oncology	4/27/2022 6:42 AM
Dates	Participating Approval Date	Update	New Registration		4/27/2022 6:42:21 AM	4/27/2022 6:42 AM
Details	State	Update	New Registration	Pending	Approved	4/27/2022 6:42 AM
Dates	Signed By Date	Update	New Registration		4/14/2022 12:03:10 PM	4/27/2022 6:42 AM
Dates	Start Date	Update	New Registration		7/1/2022 12:00:00 AM	4/27/2022 6:42 AM
Addresses	Main Address	Insert	New Registration		803 Poinciana Mamou, LA 70554	4/14/2022 12:03 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/14/2022 12:03 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1766062	4/14/2022 12:03 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		LA	4/14/2022 12:03 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1255667002	4/14/2022 12:03 PM
Medicaid Billing	NPI: State	Insert	New Registration		LA	4/14/2022 12:03 PM
Contacts	Primary Contact	Insert	New Registration		Pitre, John Pharmacy Director Savoy Medical Center 3374680149	4/14/2022 12:03 PM
Contacts	Authorizing Official	Insert	New Registration		ARMENTOR, LANCE CEO SAVOY MEDICAL MANAGEMENT GROUP, INC. 3374680350	4/14/2022 12:03 PM
Details	Assistance Received From Date	Insert	New Registration			4/14/2022 12:03 PM
Details	Assistance Received To Date	Insert	New Registration			4/14/2022 12:03 PM
Details	Last Recertification Date	Insert	New Registration			4/14/2022 12:03 PM
Details	Grant Number	Insert	New Registration			4/14/2022 12:03 PM
Details	340B ID	Insert	New Registration			4/14/2022 12:03 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/14/2022 12:03 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/14/2022 12:03 PM
Details	Medicare Provider Number	Insert	New Registration		190025	4/14/2022 12:03 PM
Details	Entity Name	Insert	New Registration		SAVOY MEDICAL MANAGEMENT GROUP INC.	4/14/2022 12:03 PM
Details	NOFO Number	Insert	New Registration			4/14/2022 12:03 PM
Details	Program Code	Insert	New Registration		DSH	4/14/2022 12:03 PM
Details	Entity Subname	Insert	New Registration		Cancer Center	4/14/2022 12:03 PM
Dates	Participating Approval Date	Insert	New Registration			4/14/2022 12:03 PM
Details	State	Insert	New Registration		Pending	4/14/2022 12:03 PM
Dates	Registration Date	Insert	New Registration		4/14/2022 12:03:03 PM	4/14/2022 12:03 PM
Dates	Signed By Date	Insert	New Registration			4/14/2022 12:03 PM
Dates	Start Date	Insert	New Registration			4/14/2022 12:03 PM
Terminations	Termination Comments	Insert	New Registration			4/14/2022 12:03 PM
Terminations	Termination Date	Insert	New Registration			4/14/2022 12:03 PM
Terminations	Termination Effective Date	Insert	New Registration			4/14/2022 12:03 PM
Terminations	Termination Reason	Insert	New Registration			4/14/2022 12:03 PM