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DSH190045F ST. TAMMANY PARISH HOSPITAL (Active)
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Main Details
Name
ST. TAMMANY PARISH HOSPITAL
Subdivision Name
PAUL D. CORDES OUTPATIENT PAVILION
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190045F
Medicare Provider Number
190045
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/10/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/18/2018
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
St. Tammany Parish Hospital
Sandra DiPietro, Senior Vice President/Chief Financial Officer
(985) 898-4583
Primary Contact
St. Tammany Parish Hospital
Lesleigh Hall, AVP Legal Affairs
(985) 871-5830
Addresses
Street Address
16300 HWY 1085
COVINGTON, LA 70734
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Initial start date 10/1/2004, Termination 10/1/2015, Reinstate 10/1/2018
07/18/2018
2/16/12 change sub entity name from outpatient paviliion to paul d cordes outpatient pavilion
02/16/2012
May 2025
May 2025
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