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SCH190007-04 NATCHITOCHES REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
NATCHITOCHES REGIONAL MEDICAL CENTER
Subdivision Name
NRMC OB/GYN
Type
Sole Community Hospital
Rural
No
340B ID
SCH190007-04
Medicare Provider Number
190007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/17/2018
Last Recertification Date
9/12/2022
Termination Date
Termination Reason
10/1/2022
Change of covered entity type
Contacts
Authorizing Official
Natchitoches Regional Medical Center
Damian K. Soileau, CEO
(318) 214-4512
Primary Contact
Natchitoches Regional Medical Center
Kassie Williams, Director of Pharmacy
(318) 214-4359
Addresses
Street Address
627 Bienville Circle
Natchitoches, LA 71457
Billing Address
Natchitoches Regional Medical Center
501 KEYSER AVE
NATCHITOCHES, LA 71457
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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