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DSH190017A OPELOUSAS GENERAL HOSPITAL (Terminated)
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Main Details
Name
OPELOUSAS GENERAL HOSPITAL
Subdivision Name
OPELOUSAS GENERAL HOSPITAL SYSTEM, SOUTH CAMPUS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190017A
Medicare Provider Number
190017
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/3/2010
Participating Start Date
4/1/2010
Participating Approval Date
3/10/2010
Last Recertification Date
8/20/2019
Termination Date
Termination Reason
7/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
190017
Jim Juneau, CFO
(337) 948-5133
Primary Contact
Opelousas General Health System
Troy Fusilier, DIRECTOR OF PHARMACY
(337) 948-5133
Addresses
Street Address
3983 I-49 SOUTH SERVICE ROAD
OPELOUSAS, LA 70570
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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