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DSH040018A BAPTIST HEALTH MEDICAL CENTER - VB (Active)
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Main Details
Name
BAPTIST HEALTH MEDICAL CENTER - VB
Subdivision Name
BH Outpatient Therapy Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH040018A
Medicare Provider Number
040018
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/19/2020
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
2020 Chestnut Street
Suite 106
Van Buren, AR 72956
Billing Address
Baptist Health - Van Buren
211 Crawford Memorial Drive
Van Buren, AR 72956
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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