340B Drug Pricing Program Database
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DSH190098AC University Health Shreveport, LLC (Active)
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Main Details
Name
University Health Shreveport, LLC
Subdivision Name
Childrens Health OLSP KH06 / SHV CHC INFECT DISEASE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH190098AC
Medicare Provider Number
190098
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/13/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/29/2016
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Ochsner LSU
Christopher Eric Mangin, CEO
(318) 205-2245
Primary Contact
BRFHH Shreveport LLC
Jason D Lafitte, Director of Pharmacy
(318) 626-0863
Addresses
Street Address
1602 KINGS HIGHWAY
UNIVERSITY HEALTH SHREVEPORT-WOMEN'S & CHILDREN'S
SHREVEPORT, LA 71103-4128
Billing Address
Ochsner LSU Health Shreveport
1541 Kings Highway
Shreveport, LA 71103
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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