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DSH040114E BAPTIST HEALTH MEDICAL CENTER - LR (Active)
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Main Details
Name
BAPTIST HEALTH MEDICAL CENTER - LR
Subdivision Name
Eye Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH040114E
Medicare Provider Number
040114
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2013
Participating Start Date
10/1/2015
Participating Approval Date
5/3/2013
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Baptist Health
Brent Beaulieu, CFO
(501) 202-2017
Primary Contact
Baptist Health
Stefanie Jaeger, Sr. Reimbursement Specialist
(501) 202-1813
Addresses
Street Address
9800 Baptist Health Drive
Little Rock, AR 72205
Billing Address
Baptist Health Medical Center - Little Rock
9601 Baptist Health Drive
Little Rock, AR 72205
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/14/15 This registration is only for the eye center department, i.e., not for every service at this location; 8/14/15 participating 7/1/13 thru 6/30/14, not participating 7/1/14 thru 9/30/15 due to DSH % below statutory minimum, reinstated based on on-line registration submitted in July 2015
08/14/2015
May 2025
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