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DSH190065C BATON ROUGE GENERAL MEDICAL CENTER (Terminated)
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Main Details
Name
BATON ROUGE GENERAL MEDICAL CENTER
Subdivision Name
BEHAVIORAL WELLNESS CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190065C
Medicare Provider Number
190065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2013
Participating Start Date
10/1/2013
Participating Approval Date
8/30/2013
Last Recertification Date
8/24/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Baton Rouge General Medical Center
Kendall Johnson, CFO
(225) 237-1645
Primary Contact
Baton Rouge General Medical Center
Kendall Johnson, CFO
(225) 237-1645
Addresses
Street Address
4739 LOUISIANA HWY 10
JACKSON, LA 70748
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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