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DSH190013A WEST CALCASIEU-CAMERON HOSPITAL (Terminated)
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Main Details
Name
WEST CALCASIEU-CAMERON HOSPITAL
Subdivision Name
ENT ASSOC W CALCASIEU CAMERON HOSPI - ENT Associates of West Calcasieu Cameron Hospital
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190013A
Medicare Provider Number
190013
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/25/2018
Last Recertification Date
9/4/2020
Termination Date
Termination Reason
10/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
West Calcasieu Cameron Hospital
Jobie James, Chief Financial Officer
(337) 527-4143
Primary Contact
West Calcasieu Cameron Hospital
Damian France, Director of Pharmacy
(337) 527-4290
Addresses
Street Address
1629 Beglis Parkway
SULPHUR, LA 70663-5641
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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