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DSH190036HK OCHSNER CLINIC FOUNDATION (Terminated)
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Main Details
Name
OCHSNER CLINIC FOUNDATION
Subdivision Name
Cardiology Nuc Med SOSP JH07 - Metairie Cardiology Nuclear Med
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190036HK
Medicare Provider Number
190036
Outpatient Facility Provider Number
190036
Additional Details
Current Program Status
Terminated
Registration Date
7/8/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/10/2014
Last Recertification Date
8/27/2021
Termination Date
Termination Reason
10/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Ochsner Health
Peter C November, EVP, CFO
(504) 842-1335
Primary Contact
Ochsner Medical Center
Myra Thomas, AVP - Pharmacy Services
(504) 842-3043
Addresses
Street Address
2005 VETERANS MEMORIAL BLVD.
METAIRIE, LA 70002-6320
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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