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DSH190036QU OCHSNER CLINIC FOUNDATION (Terminated)
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Main Details
Name
OCHSNER CLINIC FOUNDATION
Subdivision Name
Urology SCRP RR01 - Urology Destrehan
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190036QU
Medicare Provider Number
190036
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/9/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/6/2019
Last Recertification Date
Termination Date
Termination Reason
10/1/2020
Failure to recertify
Contacts
Authorizing Official
Ochsner Health System
Scott Posecai, Executive VP and Chief Financial Officer
(504) 842-4097
Primary Contact
Ochsner
Jason Chou, AVP - Pharmacy Operations
(504) 842-1195
Addresses
Street Address
13100 River Rd Suite 120
Destrehan, LA 70047
Billing Address
Ochsner Clinic Foundation
1514-1516 Jefferson Hwy
New Orleans, LA 70121
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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