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DSH040018 BAPTIST HEALTH MEDICAL CENTER - VB (Active)
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Main Details
Name
BAPTIST HEALTH MEDICAL CENTER - VB
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH040018
Medicare Provider Number
040018
Additional Details
Current Program Status
Active
Registration Date
10/10/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/29/2019
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
211 Crawford Memorial Drive
VAN BUREN, AR 72956
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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