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DSH190125A ST FRANCIS MEDICAL CENTER, INC (Terminated)
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Main Details
Name
ST FRANCIS MEDICAL CENTER, INC
Subdivision Name
ST FRANCIS PRIMARY CARE CLINIC, SUITE 309
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190125A
Medicare Provider Number
190125
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/27/2006
Participating Start Date
4/1/2006
Participating Approval Date
2/28/2006
Last Recertification Date
11/15/2017
Termination Date
Termination Reason
1/1/2018
Other
Contacts
Authorizing Official
Our Lady of Lourdes Health
Jeremy Rogers, VP, Chief Financial Officer
(337) 470-2147
Primary Contact
St. Francis Medical Center
Anna Michele Chop, Director, Pharmacy Services
(318) 966-7246
Addresses
Street Address
2600 Tower Drive
Suite 102
MONROE, LA 71201
Billing Address
ST FRANCIS PRIMARY CARE CLINIC
2600 TOWER DRIVE
309
MONROE, LA 71201
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/30/08-REMOVED MEDICAID # (WAS 1265861) PER REQUEST BY COVERED ENTITY
06/30/2008
June 2025
June 2025
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