340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH040114L BAPTIST HEALTH MEDICAL CENTER - LR (Terminated)
Print
Main Details
Name
BAPTIST HEALTH MEDICAL CENTER - LR
Subdivision Name
Vein Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH040114L
Medicare Provider Number
040114
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/4/2015
Last Recertification Date
9/13/2023
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Baptist Health
Brent Beaulieu, CFO
(501) 202-2017
Primary Contact
Baptist Health
Stefanie Jaeger, Sr. Reimbursement Specialist
(501) 202-1813
Addresses
Street Address
9501 Baptist Health Drive Suite 830
Little Rock, AR 72205
Billing Address
Baptist Health Medical Center - Little Rock
9601 Baptist Health Drive
Little Rock, AR 72205
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session