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DSH190050B BEAUREGARD MEMORIAL HOSPITAL INC. (Active)
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Main Details
Name
BEAUREGARD MEMORIAL HOSPITAL INC.
Subdivision Name
Beauregard Internal Medicine Center - Beauregard Internal Medicine Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH190050B
Medicare Provider Number
190050
Outpatient Facility Provider Number
193498
Additional Details
Current Program Status
Active
Registration Date
10/8/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/19/2021
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Beauregard Health System
Jarred Veillon, Chief Financial Officer
(337) 462-7495
Primary Contact
Beauregard Memorial Hospital
Alex Manitzas, Director of Pharmacy
(337) 462-7355
Addresses
Street Address
495 West 8th St.
DeRidder, LA 70634
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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