Covered Entity Details

SCH190007-10 NATCHITOCHES REGIONAL MEDICAL CENTER (Terminated) - information as of 5/27/2025 11:32:11 PM

Main Details

Name

NATCHITOCHES REGIONAL MEDICAL CENTER

Subdivision Name

NRMC MULTI-SPECIALTY CLINIC - GSA

Type

Sole Community Hospital

Rural

340B ID

SCH190007-10

Medicare Provider Number

190007

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

4/14/2022

Participating Start Date

7/1/2022

Participating Approval Date

6/6/2022

Last Recertification Date

9/13/2022

Termination Date
Termination Reason

10/1/2022
Change of covered entity type

Contacts

Authorizing Official

Natchitoches Regional Medical Center
Damian K. Soileau, CEO
(318) 214-4512

Primary Contact

Natchitoches Regional Medical Center
Kassie Williams, Director of Pharmacy
(318) 214-4359

Addresses

Street Address

601 KEYSER AVE
NATCHITOCHES, LA 71457-6020

Billing Address

NATCHITOCHES REGIONAL MEDICAL CENTER
501 KEYSER AVE
NATCHITOCHES, LA 71457

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	1720143	1689676835

Shipping Addresses

Shipping Address 1

NATCHITOCHES REGIONAL MEDICAL CENTER
501 KEYSER AVE
NATCHITOCHES, LA 71457

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
SCH190007-01	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NORTH NATCHITOCHES RURAL HEALTH CLINIC	3194 HWY 71	CAMPTI	LA	Terminated
SCH190007-02	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC Walk-In Clinic	740 Keyser Avenue	Natchitoches	LA	Terminated
SCH190007-03	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	Northwestern LA Cancer Center	211 Medical Drive	Natchitoches	LA	Terminated
SCH190007-04	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC OB/GYN	627 Bienville Circle	Natchitoches	LA	Terminated
SCH190007-05	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NATCHITOCHES REGIONAL MEDICAL CENTER -- Reflections - OP Psych	212 Medical Drive	Natchitoches	LA	Terminated
SCH190007-06	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC Walk-in Clinic - RHC	740 Keyser Ave.	Natchitoches	LA	Terminated
SCH190007-07	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - Orthopedics	601 KEYSER AVE	NATCHITOCHES	LA	Terminated
SCH190007-08	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - Urology	601 KEYSER AVE	NATCHITOCHES	LA	Terminated
SCH190007-09	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - Pulmonology	601 KEYSER AVE	NATCHITOCHES	LA	Terminated
SCH190007-10	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - GSA	601 KEYSER AVE	NATCHITOCHES	LA	Terminated
SCH190007-11	Child	SCH	NATCHITOCHES REGIONAL MEDICAL CENTER	NRMC MULTI-SPECIALTY CLINIC - ENT	601 KEYSER AVE	NATCHITOCHES	LA	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	10/1/2022 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		10/1/2022 12:00:00 AM	9/14/2022 7:21 AM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	9/14/2022 7:21 AM
Terminations	Termination Date	Update	Hospital Type Change Request		10/1/2022 12:00:00 AM	9/14/2022 7:21 AM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		10/1/2022 12:00:00 AM	9/14/2022 7:21 AM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	9/14/2022 7:21 AM
Contacts	Primary Contact	Update	Recertification	Powell, Anne Director of Pharmacy Natchitoches Regional Medical Center 3182144359	Williams, Kassie Director of Pharmacy Natchitoches Regional Medical Center 3182144359	9/13/2022 9:10 AM
Details	Last Recertification Date	Update	Recertification		9/13/2022 9:10:41 AM	9/13/2022 9:10 AM
Details	State	Update		Approved	Active	7/1/2022 12:01 AM
Addresses	Billing Address	Insert	New Registration		NATCHITOCHES REGIONAL MEDICAL CENTER 501 KEYSER AVE NATCHITOCHES, LA 71457	6/6/2022 5:39 PM
Addresses	Shipping Address	Insert	New Registration		NATCHITOCHES REGIONAL MEDICAL CENTER 501 KEYSER AVE NATCHITOCHES, LA 71457	6/6/2022 5:39 PM
Contacts	Signed By	Insert	New Registration		Soileau, Damian K. CEO Natchitoches Regional Medical Center 3182144512	6/6/2022 5:39 PM
Details	340B ID	Update	New Registration		SCH190007-10	6/6/2022 5:39 PM
Details	Entity Subname	Update	New Registration	NRMC MULTI-SPECIALTY CLINIC	NRMC MULTI-SPECIALTY CLINIC - GSA	6/6/2022 5:39 PM
Dates	Participating Approval Date	Update	New Registration		6/6/2022 5:39:26 PM	6/6/2022 5:39 PM
Details	State	Update	New Registration	Pending	Approved	6/6/2022 5:39 PM
Dates	Signed By Date	Update	New Registration		6/6/2022 9:34:42 AM	6/6/2022 5:39 PM
Dates	Start Date	Update	New Registration		7/1/2022 12:00:00 AM	6/6/2022 5:39 PM
Addresses	Main Address	Insert	New Registration		601 KEYSER AVE NATCHITOCHES, LA 71457-6020	4/14/2022 6:00 PM
Addresses	Billing Address	Insert	New Registration		NRMC OUTPATIENT PHARMACY 501 KEYSER AVE NATCHITOCHES, LA 71457	4/14/2022 6:00 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/14/2022 6:00 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1720143	4/14/2022 6:00 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		LA	4/14/2022 6:00 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1689676835	4/14/2022 6:00 PM
Medicaid Billing	NPI: State	Insert	New Registration		LA	4/14/2022 6:00 PM
Contacts	Authorizing Official	Insert	New Registration		Soileau, Damian K. CEO Natchitoches Regional Medical Center 3182144512	4/14/2022 6:00 PM
Contacts	Primary Contact	Insert	New Registration		Powell, Anne Director of Pharmacy Natchitoches Regional Medical Center 3182144359	4/14/2022 6:00 PM
Details	Assistance Received From Date	Insert	New Registration			4/14/2022 6:00 PM
Details	Assistance Received To Date	Insert	New Registration			4/14/2022 6:00 PM
Details	Last Recertification Date	Insert	New Registration			4/14/2022 6:00 PM
Details	Grant Number	Insert	New Registration			4/14/2022 6:00 PM
Details	340B ID	Insert	New Registration			4/14/2022 6:00 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/14/2022 6:00 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/14/2022 6:00 PM
Details	Medicare Provider Number	Insert	New Registration		190007	4/14/2022 6:00 PM
Details	Entity Name	Insert	New Registration		NATCHITOCHES REGIONAL MEDICAL CENTER	4/14/2022 6:00 PM
Details	NOFO Number	Insert	New Registration			4/14/2022 6:00 PM
Details	Program Code	Insert	New Registration		SCH	4/14/2022 6:00 PM
Details	Entity Subname	Insert	New Registration		NRMC MULTI-SPECIALTY CLINIC	4/14/2022 6:00 PM
Dates	Participating Approval Date	Insert	New Registration			4/14/2022 6:00 PM
Details	State	Insert	New Registration		Pending	4/14/2022 6:00 PM
Dates	Registration Date	Insert	New Registration		4/14/2022 6:00:31 PM	4/14/2022 6:00 PM
Dates	Signed By Date	Insert	New Registration			4/14/2022 6:00 PM
Dates	Start Date	Insert	New Registration			4/14/2022 6:00 PM
Terminations	Termination Comments	Insert	New Registration			4/14/2022 6:00 PM
Terminations	Termination Date	Insert	New Registration			4/14/2022 6:00 PM
Terminations	Termination Effective Date	Insert	New Registration			4/14/2022 6:00 PM
Terminations	Termination Reason	Insert	New Registration			4/14/2022 6:00 PM