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CAH191314-00 MADISON PARISH HOSPITAL (Active)
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Main Details
Name
MADISON PARISH HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH191314-00
Medicare Provider Number
191314
Additional Details
Current Program Status
Active
Registration Date
7/14/2022
Participating Start Date
10/1/2022
Participating Approval Date
8/2/2022
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Madison Parish Hospital
Russ Hawkins, CFO
(318) 651-5604
Primary Contact
Madison Parish Hospital
Kim Martin, Controller
(318) 651-5603
Addresses
Street Address
900 Johnson Street
TALLULAH, LA 71282
Billing Address
Madison Parish Hospital Service District
P.O.Box 1559
Tallulah, LA 71284
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2012, terminated 10/1/2013. Reinstated 10/1/2022.
07/26/2022
May 2025
May 2025
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