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SCH190007-02 NATCHITOCHES REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
NATCHITOCHES REGIONAL MEDICAL CENTER
Subdivision Name
NRMC Walk-In Clinic
Type
Sole Community Hospital
Rural
No
340B ID
SCH190007-02
Medicare Provider Number
190007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/8/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/8/2016
Last Recertification Date
9/4/2018
Termination Date
Termination Reason
7/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Natchitoches Regional Medical Center
Damian K. Soileau, CEO
(318) 214-4512
Primary Contact
Natchitoches Regional Medical Center
Anne Powell, Director of Pharmacy
(318) 214-4359
Addresses
Street Address
740 Keyser Avenue
Natchitoches Regional Medical Center Walk-In Clinic
Natchitoches, LA 71457
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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