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PED193300-22 Children's Hospital (Terminated)
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Main Details
Name
Children's Hospital
Subdivision Name
CHILDRENS HOSPITAL INC - Kids First Tiger Care
Type
Children's Hospital
Rural
No
340B ID
PED193300-22
Medicare Provider Number
193300
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/4/2020
Last Recertification Date
9/15/2022
Termination Date
Termination Reason
1/1/2023
Site closure
Contacts
Authorizing Official
Children's Hospital
John R Nickens, President & CEO
(504) 896-9452
Primary Contact
Children's Hospital
Lindy C Bosworth, Director of Pharmacy
(504) 894-6764
Addresses
Street Address
2633 NAPOLEAN AVENUE SUITE 707
NAPOLEAN PEDIATRICS
NEW ORLEANS, LA 70115-6357
Billing Address
Children's Hospital
200 Henry Clay Ave
New Orleans, LA 70118
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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