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DSH190046AC TOURO INFIRMARY (Terminated)
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Main Details
Name
TOURO INFIRMARY
Subdivision Name
Internal Medicine - Internal Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190046AC
Medicare Provider Number
190046
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/16/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/24/2017
Last Recertification Date
9/5/2023
Termination Date
Termination Reason
10/1/2024
Site closure
Contacts
Authorizing Official
Touro Infirmary
Stephen Matthew Baldwin, Chief Operating Officer
(504) 897-8566
Primary Contact
Touro Infirmary
Tara Montgomery, Director of Pharmacy
(504) 897-8071 Ext: 7515
Addresses
Street Address
3525 Prytania Street
Suite 301
New Orleans, LA 70115
Billing Address
Touro Infirmary
1401 Foucher Street
1401 Foucher Street
New Orleans, LA 70115
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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