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DSH190202BQ OCHSNER MEDICAL CENTER- BATON ROUGE, LLC (Terminated)
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Main Details
Name
OCHSNER MEDICAL CENTER- BATON ROUGE, LLC
Subdivision Name
OCHSNER MEDICAL CENTER- BATON ROUGE, LLC DIABETES ONL
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190202BQ
Medicare Provider Number
190202
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/25/2014
Last Recertification Date
9/8/2014
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Ochsner Medical Center Baton Rouge
Dianne Teal, Chief Nursing officer
(225) 755-4983
Primary Contact
Ochsner Medical Center
Heather Maturin, Director of Pharmacy
(225) 755-4810
Addresses
Street Address
16777 Medical Center Dr
Baton Rouge, LA 70816
Billing Address
OCHSNER MEDICAL CENTER- BATON ROUGE, LLC
17000 Medical Center Drive
Baton Rouge, LA 70816
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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