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DSH190020 LANE REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
LANE REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190020
Medicare Provider Number
190020
Additional Details
Current Program Status
Active
Registration Date
3/10/2008
Participating Start Date
4/1/2008
Participating Approval Date
3/11/2008
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Lane Regional Medical Center
Frank Corcoran, CEO
(225) 658-4303
Primary Contact
Lane Regional Medical Center
Jassoni Shae Martin, Director of Pharmacy
(225) 658-4364
Addresses
Street Address
6300 MAIN STREET
ZACHARY, LA 70791
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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