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DSH190040S Slidell Memorial Hospital (Active)
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Main Details
Name
Slidell Memorial Hospital
Subdivision Name
SMH Imaging Radiology - SMHH XRAY IMAGING CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190040S
Medicare Provider Number
190040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/31/2024
Last Recertification Date
Contacts
Authorizing Official
Slidell Memorial Hospital
Sandy T Badinger, CEO
(504) 881-7056
Primary Contact
Slidell Memorial Hospital
Kisha Gant O'Neal Gant, Director of Pharmacy
(985) 280-7667
Addresses
Street Address
1495 Gause Boulevard
Slidell, LA 70458
Billing Address
Ochsner Clinic Foundation - Accounts Payable
1201 Dickory Ave
New Orleans, LA 70123
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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