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DON CHAUCER'S PHARMACY
DSH190015 North Oaks Medical Center LLC
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Covered Entity Details
Entity Name
North Oaks Medical Center LLC
Subdivision Name
DBA NORTH OAKS MEDICAL CENTER LLC
Type
Disproportionate Share Hospital
340B ID
DSH190015
Entity Address
15790 PAUL VEGA M.D. DRIVE
HAMMOND, LA 70403
Medicare Provider Number
190015
Participating Start Date
4/1/2005
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
DON CHAUCER'S PHARMACY
Pharmacy Address
15794 MEDICAL ARTS DR
HAMMOND, LA 70403-1446
Pharmacy Comments
Contract Details
Approval Date
10/11/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/18/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
SHIRLEY HSING, CFO
(985) 230-6655
Contract Pharmacy Representative
Terri Chaucer, Representative
(985) 345-7979
Signed By Date
10/11/2013
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