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CAH191304-02 NORTH CADDO MEDICAL CENTER (Active)
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Main Details
Name
NORTH CADDO MEDICAL CENTER
Subdivision Name
NCMC MEDICAL AND SURGICAL CLINIC
Type
Critical Access Hospital
Rural
No
340B ID
CAH191304-02
Medicare Provider Number
191304
Outpatient Facility Provider Number
193476
Additional Details
Current Program Status
Active
Registration Date
4/14/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/29/2016
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
North Caddo Medical Center
David Jones, CEO
(318) 375-4001
Primary Contact
North Caddo Hospital Service District
Dakota Robinson, Controller
(318) 375-4097
Addresses
Street Address
815 South Pine
VIVIAN, LA 71082-3351
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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