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DSH190039Q WEST JEFFERSON HOLDINGS, LLC D/B/A WEST JEFFERSON MEDICAL CENTER (Active)
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Main Details
Name
WEST JEFFERSON HOLDINGS, LLC D/B/A WEST JEFFERSON MEDICAL CENTER
Subdivision Name
WEST JEFFERSON MEDICAL CENTER FAMIL - Family Doctors- Algiers
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190039Q
Medicare Provider Number
190039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/20/2021
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
West Jefferson Medical Center
Chad Miller, CFO
(504) 349-6021
Primary Contact
West Jefferson Medical Center
Cheryl L JacksonBrown, Phamacy Director
(504) 349-1700
Addresses
Street Address
3712 MACARTHUR BLVD
STE 202
NEW ORLEANS, LA 70114-6866
Billing Address
West Jefferson Medical Center
1101 Medical Center Blvd.
Marrero, LA 70072
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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