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DSH040055J Baptist Health - Fort Smith (Active)
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Main Details
Name
Baptist Health - Fort Smith
Subdivision Name
BH Imaging Center - Fort Smith
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040055J
Medicare Provider Number
040055
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/30/2019
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Baptist Health
Brent Beaulieu, CFO
(501) 202-2017
Primary Contact
Baptist Health
Stefanie Jaeger, Sr. Reimbursement Specialist
(501) 202-1813
Addresses
Street Address
1500 Dodson Avenue
Suite 130
Fort Smith, AR 72901
Billing Address
Baptist Health - Fort Smith
1001 Towson Avenue
Fort Smith, AR 72901
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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