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DSH190013B WEST CALCASIEU-CAMERON HOSPITAL (Active)
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Main Details
Name
WEST CALCASIEU-CAMERON HOSPITAL
Subdivision Name
W CALCASIEU CAMERON HOSP VINTON MED - Vinton Medical Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190013B
Medicare Provider Number
190013
Outpatient Facility Provider Number
193458
Additional Details
Current Program Status
Active
Registration Date
7/13/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/25/2018
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
West Calcasieu Cameron Hospital
Jobie James, Chief Financial Officer
(337) 527-4143
Primary Contact
West Calcasieu-Cameron Hospital
GLYN J FOREMAN, Director of Pharmacy
(337) 527-4290
Addresses
Street Address
1611 HAMPTON STREET
VINTON, LA 70668-3707
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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