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DSH190065M BATON ROUGE GENERAL MEDICAL CENTER (Active)
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Main Details
Name
BATON ROUGE GENERAL MEDICAL CENTER
Subdivision Name
BATON ROUGE GENERAL - CENTER FOR HEALTH - OUTPATIENT THERAPY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190065M
Medicare Provider Number
190065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/10/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/10/2019
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Baton Rouge General Medical Center
Kendall Johnson, CFO
(225) 237-1645
Primary Contact
Baton Rouge General Health System
Raneesha Ford, Director, Pharmacy Services
(225) 763-4087
Addresses
Street Address
9001 SUMMA AVE
Suite 140
BATON ROUGE, LA 70809
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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