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DSH190006A UNIVERSITY HOSPITAL AND CLINICS (Active)
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Main Details
Name
UNIVERSITY HOSPITAL AND CLINICS
Subdivision Name
Ophthalmology UHCP GR02 - USJC OPHTHALMOLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190006A
Medicare Provider Number
190006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/6/2013
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
University Hospital and Clinics
Glenn Dailey, CEO
(337) 261-6005
Primary Contact
University Hospital & Clinics
Amy Ranson, Pharmacy Manager
(337) 261-6229
Addresses
Street Address
401 St. Julien
Lafayette, LA 70506
Billing Address
Ochsner Clinic Foundation - Accounts Payable
1201 Dickory Ave
New Orleans, LA 70123
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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