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DSH190004 THIBODAUX REGIONAL HEALTH SYSTEM (Active)
Main Details
Name
THIBODAUX REGIONAL HEALTH SYSTEM
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190004
Medicare Provider Number
190004
Contacts
Authorizing Official
Thibodaux Regional Health System
Stephen H East, Chief Financial Officer
(985) 446-5033 Ext: 4740
Primary Contact
Thibodaux Regional Medical Center
April Benoit Denning, Director of Pharmacy
(985) 493-4545
Additional Details
Current Program Status
Active
Registration Date
7/10/2019
Participating Start Date
10/1/2019
Participating Approval Date
9/4/2019
Last Recertification Date
9/8/2023
Addresses
Street Address
602 NORTH ACADIA ROAD
THIBODAUX, LA 70301
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2024
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