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DSH190039 WEST JEFFERSON HOLDINGS, LLC D/B/A WEST JEFFERSON MEDICAL CENTER (Active)
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Main Details
Name
WEST JEFFERSON HOLDINGS, LLC D/B/A WEST JEFFERSON MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190039
Medicare Provider Number
190039
Additional Details
Current Program Status
Active
Registration Date
11/22/2005
Participating Start Date
11/25/2005
Participating Approval Date
11/25/2005
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
West Jefferson Medical Center
Chad Miller, CFO
(504) 349-6021
Primary Contact
West Jefferson Medical Center
Cheryl L JacksonBrown, Phamacy Director
(504) 349-1700
Addresses
Street Address
1101 MEDICAL CENTER BLVD
MARRERO, LA 70072
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/4/2012 - UPDATED AUTHORIZING OFFICIAL 2/11/2010- UPDATED AUTHORIZING OFFICIAL INFO.
01/04/2012
2/11/2010- UPDATED AUTHORIZING OFFICIAL INFO.
02/11/2010
April 2025
April 2025
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