Covered Entity Details

DSH190019Q CHRISTUS ST FRANCES CABRINI HOSPITAL (Active) - information as of 4/28/2025 12:44:27 AM

Main Details

Name

CHRISTUS ST FRANCES CABRINI HOSPITAL

Subdivision Name

CANCER CENTER NORTH - Cancer Services

Type

Disproportionate Share Hospital

Rural

340B ID

DSH190019Q

Medicare Provider Number

190019

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/3/2023

Participating Start Date

4/1/2023

Participating Approval Date

1/4/2023

Last Recertification Date

8/16/2024

Contacts

Authorizing Official

CHRISTUS St. Frances Cabrini Health System
Monte Wilson, CEO
(318) 448-6701

Primary Contact

CHRISTUS St. Frances Cabrini
Spencer Gauthreaux, Director of Pharmacy
(318) 448-6977

Addresses

Street Address

2108 TEXAS AVE
STE 3061
ALEXANDRIA, LA 71301-3903

Billing Address

CHRISTUS ST FRANCES CABRINI HOSPITAL
3330 MASONIC DRIVE
ALEXANDRIA, LA 71301

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	1720208,2202707	1144221565,1639160799
TX		1639160799

Shipping Addresses

Shipping Address 1

CHRISTUS ST FRANCES CABRINI HOSPITAL
3330 MASONIC DRIVE
ALEXANDRIA, LA 71301

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
DSH190019A	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Central Louisiana Imaging Center	3704 North Boulevard	Alexandria	LA	Active
DSH190019E	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Health Central Louisiana Incarnate Word Community Clinic Ophthalmology Clinic	3351 Masonic Drive	Alexandria	LA	Terminated
DSH190019F	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Health Central Louisiana Incarnate Word Community Clinic - Coumadin Clinic	3351 Masonic Drive	Alexandria	LA	Terminated
DSH190019G	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Health Central Louisiana Incarnate Word Community Clinic - Specialty Care Clinic	3351 Masonic Drive	Alexandria	LA	Active
DSH190019H	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Health Central Louisiana Incarnate Word Community Clinic - Gynacology Clinic	3351 Masonic Drive	Alexandria	LA	Terminated
DSH190019J	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Health Central Louisiana Incarnate Word Community Clinic - Cardiology Clinic	3351 Masonic Drive	Alexandria	LA	Terminated
DSH190019K	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Health Central Louisiana Incarnate Word Community Clinic - Primary/Urgent Care Clinic	3000 South MacArthur Drive	Alexandria	LA	Active
DSH190019L	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Health Central Louisiana Incarnate Word Community Clinic Orthopedic Clinic	3351 Masonic Drive	Alexandria	LA	Terminated
DSH190019M	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Health Central Louisiana Incarnate Word Community Clinic - Pediatric Care Clinic	3351 Masonic Drive	Alexandria	LA	Terminated
DSH190019N	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CHRISTUS Health Central Louisiana Incarnate Word Community Clinic - Urgent Care Clinic	3351 Masonic Drive	Alexandria	LA	Terminated
DSH190019P	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	Christus Community Clinic Pineville - Clinic	308 Griffith Street	Pineville	LA	Active
DSH190019Q	Child	DSH	CHRISTUS ST FRANCES CABRINI HOSPITAL	CANCER CENTER NORTH - Cancer Services	2108 TEXAS AVE	ALEXANDRIA	LA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/16/2023 2:48:00 PM	8/16/2024 12:10:36 PM	8/16/2024 12:10 PM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1639160799	11/30/2023 2:02 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		TX	11/30/2023 2:02 PM
Details	Last Recertification Date	Update	Recertification		8/16/2023 2:48:00 PM	8/16/2023 2:48 PM
Contacts	Authorizing Official	Update	AO Change Request	Shaughnessy, John P CFO CHRISTUS St. Frances Cabrini 3185283550	Wilson, Monte CEO CHRISTUS St. Frances Cabrini Health System 3184486701	7/10/2023 7:06 AM
Details	State	Update		Approved	Active	4/1/2023 12:01 AM
Contacts	Signed By	Insert	New Registration		Shaughnessy, John P CFO CHRISTUS St. Frances Cabrini 3185283550	1/4/2023 7:56 AM
Details	340B ID	Update	New Registration		DSH190019Q	1/4/2023 7:56 AM
Details	Entity Name	Update	New Registration	ST. FRANCES CABRINI HOSPITAL	CHRISTUS ST FRANCES CABRINI HOSPITAL	1/4/2023 7:56 AM
Details	Entity Subname	Update	New Registration	CANCER CENTER NORTH	CANCER CENTER NORTH - Cancer Services	1/4/2023 7:56 AM
Dates	Participating Approval Date	Update	New Registration		1/4/2023 7:56:40 AM	1/4/2023 7:56 AM
Details	State	Update	New Registration	Pending	Approved	1/4/2023 7:56 AM
Dates	Signed By Date	Update	New Registration		1/3/2023 5:01:04 PM	1/4/2023 7:56 AM
Dates	Start Date	Update	New Registration		4/1/2023 12:00:00 AM	1/4/2023 7:56 AM
Addresses	Main Address	Insert	New Registration		2108 TEXAS AVE STE 3061 ALEXANDRIA, LA 71301-3903	1/3/2023 5:00 PM
Addresses	Billing Address	Insert	New Registration		CHRISTUS ST FRANCES CABRINI HOSPITAL 3330 MASONIC DRIVE ALEXANDRIA, LA 71301	1/3/2023 5:00 PM
Addresses	Shipping Address	Insert	New Registration		CHRISTUS ST FRANCES CABRINI HOSPITAL 3330 MASONIC DRIVE ALEXANDRIA, LA 71301	1/3/2023 5:00 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/3/2023 5:00 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		1720208	1/3/2023 5:00 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		LA	1/3/2023 5:00 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/3/2023 5:00 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		2202707	1/3/2023 5:00 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		LA	1/3/2023 5:00 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1144221565	1/3/2023 5:00 PM
Medicaid Billing	NPI: State	Insert	New Registration		LA	1/3/2023 5:00 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1639160799	1/3/2023 5:00 PM
Medicaid Billing	NPI: State	Insert	New Registration		LA	1/3/2023 5:00 PM
Contacts	Authorizing Official	Insert	New Registration		Shaughnessy, John P CFO CHRISTUS St. Frances Cabrini 3185283550	1/3/2023 5:00 PM
Contacts	Primary Contact	Insert	New Registration		Gauthreaux, Spencer Director of Pharmacy CHRISTUS St. Frances Cabrini 3184486977	1/3/2023 5:00 PM
Details	Assistance Received From Date	Insert	New Registration			1/3/2023 5:00 PM
Details	Assistance Received To Date	Insert	New Registration			1/3/2023 5:00 PM
Details	Last Recertification Date	Insert	New Registration			1/3/2023 5:00 PM
Details	Grant Number	Insert	New Registration			1/3/2023 5:00 PM
Details	340B ID	Insert	New Registration			1/3/2023 5:00 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/3/2023 5:00 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/3/2023 5:00 PM
Details	Medicare Provider Number	Insert	New Registration		190019	1/3/2023 5:00 PM
Details	Entity Name	Insert	New Registration		ST. FRANCES CABRINI HOSPITAL	1/3/2023 5:00 PM
Details	NOFO Number	Insert	New Registration			1/3/2023 5:00 PM
Details	Program Code	Insert	New Registration		DSH	1/3/2023 5:00 PM
Details	Entity Subname	Insert	New Registration		CANCER CENTER NORTH	1/3/2023 5:00 PM
Dates	Participating Approval Date	Insert	New Registration			1/3/2023 5:00 PM
Details	State	Insert	New Registration		Pending	1/3/2023 5:00 PM
Dates	Registration Date	Insert	New Registration		1/3/2023 5:00:59 PM	1/3/2023 5:00 PM
Dates	Signed By Date	Insert	New Registration			1/3/2023 5:00 PM
Dates	Start Date	Insert	New Registration			1/3/2023 5:00 PM
Terminations	Termination Comments	Insert	New Registration			1/3/2023 5:00 PM
Terminations	Termination Date	Insert	New Registration			1/3/2023 5:00 PM
Terminations	Termination Effective Date	Insert	New Registration			1/3/2023 5:00 PM
Terminations	Termination Reason	Insert	New Registration			1/3/2023 5:00 PM