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DSH190039P WEST JEFFERSON HOLDINGS, LLC D/B/A WEST JEFFERSON MEDICAL CENTER (Active)
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Main Details
Name
WEST JEFFERSON HOLDINGS, LLC D/B/A WEST JEFFERSON MEDICAL CENTER
Subdivision Name
West Jefferson Medical Center Infusion Center - Oncology - Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190039P
Medicare Provider Number
190039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/9/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/31/2019
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
West Jefferson Medical Center
Chad Miller, CFO
(504) 349-6021
Primary Contact
West Jefferson Medical Center
Cheryl L JacksonBrown, Phamacy Director
(504) 349-1700
Addresses
Street Address
4511 Westbank Expressway
Marrero, LA 70072
Billing Address
West Jefferson Medical Center
1101 Medical Center Boulevard
Marrero, LA 70072
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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