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DSH190060 Southwest Louisiana Hospital Association d/b/a Lake Charles Memorial Hospital (Active)
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Main Details
Name
Southwest Louisiana Hospital Association d/b/a Lake Charles Memorial Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH190060
Medicare Provider Number
190060
Additional Details
Current Program Status
Active
Registration Date
9/12/2007
Participating Start Date
1/1/2005
Participating Approval Date
9/12/2007
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Lake Charles Memorial Hospital
Devon Hyde, President/CEO
(337) 494-3200
Primary Contact
Lake Charles Memorial Hospital
Julia Manuel, Health-System Director of Pharmacy
(337) 494-3182
Addresses
Street Address
1701 OAK PARK BOULEVARD
LAKE CHARLES, LA 70601
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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