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DSH190202HB OCHSNER MEDICAL CENTER- BATON ROUGE, LLC (Terminated)
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Main Details
Name
OCHSNER MEDICAL CENTER- BATON ROUGE, LLC
Subdivision Name
Peds Oncology BNRP TG01 - HGVC PEDIATRIC ONCOLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH190202HB
Medicare Provider Number
190202
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/11/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/13/2023
Last Recertification Date
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Ochsner Medical Center Baton Rouge
Dianne Teal, Chief Nursing officer
(225) 755-4983
Primary Contact
Ochsner Medical Center
Heather Maturin, Director of Pharmacy
(225) 755-4810
Addresses
Street Address
10310 The Grove Boulevard
Baton Rouge, LA 70836
Billing Address
Ochsner Clinic Foundation - Accounts Payable
1201 Dickory Ave
New Orleans, LA 70123
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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