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DSH190020A LANE REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
LANE REGIONAL MEDICAL CENTER
Subdivision Name
LANE REGIONAL MEDICAL CENTER BEHAVI
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190020A
Medicare Provider Number
190020
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/6/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/22/2015
Last Recertification Date
8/15/2018
Termination Date
Termination Reason
10/1/2018
Site closure
Contacts
Authorizing Official
Lane Regional Medcial Center
Phil Hacker, Chief Financial Officer
(225) 658-4505
Primary Contact
Lane Regional Medical Center
Jennie Stelly, DIRECTOR OF PHARMACY
(225) 658-4364
Addresses
Street Address
4801 McHugh
SUITE A / B
ZACHARY, LA 70791-9984
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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