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DSH150109 FRANCISCAN HEALTH LAFAYETTE (Active)
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Main Details
Name
FRANCISCAN HEALTH LAFAYETTE
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150109
Medicare Provider Number
150109
Additional Details
Current Program Status
Active
Registration Date
4/6/2021
Participating Start Date
4/26/2021
Participating Approval Date
4/19/2021
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Franciscan Health
Jason Geddes, Regional CFO
(765) 502-4599
Primary Contact
Franciscan Health
Laura Shondell, Administrative Director Medication Systems and Operations
(765) 423-6900
Addresses
Street Address
1701 SOUTH CREASY LANE
LAFAYETTE, IN 47905
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 7/1/2006, Termination 10/1/2020, Reinstatement 4/26/2021
04/26/2021
3/14/12 name cahnge information provided 3/17/10 NAME CHANGE & ADDR CHANGE (WAS HOME HOSPITAL 2400 SOUTH STREET)8/25/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
03/14/2012
3/17/10 NAME CHANGE & ADDR CHANGE (WAS HOME HOSPITAL 2400 SOUTH STREET)8/25/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
03/17/2010
April 2025
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