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DSH190208A EAST CARROLL PARISH HOSPITAL (Active)
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Main Details
Name
EAST CARROLL PARISH HOSPITAL
Subdivision Name
Family Medical Clinic - Primary Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH190208A
Medicare Provider Number
190208
Outpatient Facility Provider Number
193464
Additional Details
Current Program Status
Active
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
3/10/2020
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
East Carroll Parish Hospital
LaDonna Englerth, Administrator
(318) 559-4023 Ext: 103
Primary Contact
East Carroll Parish Hospital
Tracie Russell, Pharmacy Manager
(318) 559-4023 Ext: 108
Addresses
Street Address
326 North Hood Street
Lake Providence, LA 71254
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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