340B Drug Pricing Program Database
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DSH190118C DESOTO REGIONAL HEALTH SYSTEM (Active)
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Main Details
Name
DESOTO REGIONAL HEALTH SYSTEM
Subdivision Name
DESOTO REGIONAL FAMILY MEDICINE MANSFIELD
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190118C
Medicare Provider Number
190118
Outpatient Facility Provider Number
193480
Additional Details
Current Program Status
Active
Registration Date
10/15/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/26/2013
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
DeSoto Regional
TODD EPPLER, CEO
(318) 871-3132
Primary Contact
DeSoto Hospital Association, Inc
Vicki Barnes, Pharmacy Director
(318) 872-4610
Addresses
Street Address
130 JEFFERSON STREET
MANSFIELD, LA 71052
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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