Covered Entity Details

CH06338G SWLA CENTER FOR HEALTH SERVICES (Active) - information as of 6/4/2025 1:21:16 PM

Main Details

Name

SWLA CENTER FOR HEALTH SERVICES

Subdivision Name

SWLA Center for Health Services--DeBakey Drive Temporary Location

Type

HRSA-Funded Health Center

Site ID

BPS-H80-034447

340B ID

CH06338G

Grant Number

H80CS00558

Additional Details

Current Program Status

Active

Registration Date

3/10/2025

Participating Start Date

4/1/2025

Participating Approval Date

3/12/2025

Last Recertification Date

Contacts

Authorizing Official

SWLA CENTER FOR HEALTH SERVICES
Jason Ng, CFO
(337) 488-8008

Primary Contact

SWLA Center for Health Services
Pamela Duplechain-Cellum, Pharmacist
(337) 439-9983

Addresses

Street Address

501 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5724

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH063380	Active	BPS-H80-003178	SWLA CENTER FOR HEALTH SERVICES	SOUTHWEST LOUISIANA CENTER FOR HEALTH SERVICES	2000 Opelousas St	Lake Charles	LA
CH06338A	Active	BPS-H80-011096	SWLA CENTER FOR HEALTH SERVICES	SWLA Center for Health Services - Lafayette	500 Patterson St	Lafayette	LA
CH06338B	Active	BPS-H80-027695	SWLA CENTER FOR HEALTH SERVICES	SWLA Center for Health Services - Crowley and Rayne	526 CROWLEY RAYNE HWY	Crowley	LA
CH06338C	Active	BPS-H80-012691	SWLA CENTER FOR HEALTH SERVICES	SWLA Center For Health Services - Oberlin	112 N Sixth St	Oberlin	LA
CH06338D	Active	BPS-H80-031327	SWLA Center For Health Services	Temporary Site- SWLA MOBILE UNIT	2000 Opelousas St	Lake Charles	LA
CH06338E	Terminated	BPS-H80-030099	SWLA Center For Health Services	SWLA Center for Health Services - Sowela	3820 Sen J Bennett Johnston Ave Bldg 8	Lake Charles	LA
CH06338F	Active	BPS-H80-035565	SWLA CENTER FOR HEALTH SERVICES	SWLA--JD Clifton Elementary School	100 N Prater	Lake Charles	LA
CH06338G	Active	BPS-H80-034447	SWLA CENTER FOR HEALTH SERVICES	SWLA Center for Health Services--DeBakey Drive Temporary Location	501 Doctor Michael Debakey Dr	Lake Charles	LA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH063380	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	07/01/2024
CH063380	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	07/01/2024
CH063380	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	07/01/2024
CH063380	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	07/01/2024
CH063380	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	07/01/2024
CH063380	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	07/01/2024
CH063380	BROTHER'S PHARMACY	BROTHER'S PHARMACY LLC	6200 LESLIE LN	LAKE CHARLES	LA	70615	01/01/2024
CH063380	CENTERWELL PHARMACY, INC.	9843 WINDISCH RD		WEST CHESTER	OH	45069	01/01/2024
CH063380	CENTERWELL PHARMACY, INC.	11010 FLORIDA CROWN DRIVE, SUITE 200		ORLANDO	FL	32824	01/01/2024
CH063380	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	07/01/2024
CH063380	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	07/01/2024
CH063380	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	07/01/2024
CH063380	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	07/01/2024
CH063380	FRED'S PHARMACY # 2124	715 1ST AVE		KINDER	LA	70648-3511	01/01/2018	07/01/2022
CH063380	INVERNESS APOTHECARY TRINITY	24333 GORDON TERRY PARKWAY	SUITE B	TRINITY	AL	35673	05/06/2022
CH063380	LOUISIANA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 00266	2000 RYAN ST.	LAKE CHARLES	LA	70601	04/01/2020
CH063380	LOUISIANA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05285	1315 MOSS ST EXT	LAFAYETTE	LA	70501	04/01/2020
CH063380	LOUISIANA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05554	111 WESTGATE RD.	LAFAYETTE	LA	70506	04/01/2020
CH063380	LOUISIANA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01099	4828 NELSON RD.	LAKE CHARLES	LA	70605	01/01/2021
CH063380	LOUISIANA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05292	1013 EAST LANDRY STREET	OPELOUSAS	LA	70570	01/01/2021
CH063380	LOUISIANA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05443	1920 KALISTE SALOOM	LAFAYETTE	LA	70508	01/01/2021
CH063380	LOUISIANA CVS PHARMACY, L.L.C.	CVS PHARMACY # 16738	1720 W PRIEN LAKE RD	LAKE CHARLES	LA	70601	01/01/2021
CH063380	VITAL RX LLC	237 CAHABA VALLEY PARKWAY		PELHAM	AL	35124	05/06/2022
CH063380	VITAL RX OF LOUISIANA	6200 LESLIE LN		LAKE CHARLES	LA	70615	05/06/2022
CH063380	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2019
CH063380	WAL-MART PHARMACY 10-0310	729 ODDFELLOWS ROAD		CROWLEY	LA	70526	01/01/2024
CH063380	WAL-MART PHARMACY 10-0469	3415 US 14		LAKE CHARLES	LA	70607	10/01/2022
CH063380	WAL-MART PHARMACY 10-0521	2500 N MARTIN LUTHER KING HWY		LAKE CHARLES	LA	70601	07/01/2017
CH063380	WAL-MART PHARMACY 10-0534	1229 NW EVANGELINE THRUWAY		LAFAYETTE	LA	70501	07/01/2017	07/01/2022
CH063380	WAL-MART PHARMACY 10-1107	1900 HWY 165 SOUTH		OAKDALE	LA	71463	07/01/2017
CH063380	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2019
CH063380	WAL-MART PHARMACY 10-7301	3810 NE EVANGELINE THRUWAY		CARENCRO	LA	70520-5966	10/01/2022
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03373	2000 GERTSNER MEMORIAL DR	LAKE CHARLES	LA	70601-8060	07/01/2014	04/01/2023
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 06219	2636 RYAN ST	LAKE CHARLES	LA	70601	07/01/2014
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 07197	120 N HIGHWAY 171	MOSS BLUFF	LA	70611-5343	07/01/2014
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #10508	4097 RYAN ST	LAKE CHARLES	LA	70605-2819	07/01/2014
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #12428	920 W. GLORIA SWITCH RD	LAFAYETTE	LA	70507	07/01/2014
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 02920	1021 BEGLIS PKWY	SULPHUR	LA	70663	04/01/2015
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 09862	1204 THE BLVD	RAYNE	LA	70578-6219	01/01/2017
CH063380	WALGREEN LOUISIANA CO., INC.	WALGREENS #15587	2030 MAIN ST	FRANKLIN	LA	70538	01/01/2017
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #11997	5416 CAMERON ST	SCOTT	LA	70583	01/01/2017
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 05629	2822 AMBASSADOR CAFFERY PKWY	LAFAYETTE	LA	70506	01/01/2017
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #10577	1804 ELTON RD	JENNINGS	LA	70546-3002	01/01/2017
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 10399	806 ODD FELLOWS RD	CROWLEY	LA	70526-2214	01/01/2017
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 05747	3747 MOSS STREET	LAFAYETTE	LA	70507	01/01/2017	03/20/2025
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 07696	1401 REES STREET	BREAUX BRIDGE	LA	70517-4307	01/01/2017
CH063380	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 04566	2700 JOHNSTON ST.	LAFAYETTE	LA	70503	01/01/2017
CH063380	Walgreens #21373	Walgreens Central Fill #21373	4100 Dale Earnhardt Way STE 200	Northlake	TX	76262	10/01/2022
CH063380	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/01/2014	08/17/2015
CH063380	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/01/2024
CH063380	WALMART PHARMACY 10-6583	2011 RYAN STREET		LAKE CHARLES	LA	70601	01/01/2024
CH063380	WALMART PHARMACY 10-6590	260 SAM HOUSTON JONES PKWY		LAKE CHARLES	LA	70611	07/01/2017
CH063380	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	4/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		Ng, Jason CFO SWLA CENTER FOR HEALTH SERVICES 3374888008	3/12/2025 8:44 AM
Details	340B ID	Update	New Registration		CH06338G	3/12/2025 8:44 AM
Dates	Participating Approval Date	Update	New Registration		3/12/2025 8:44:48 AM	3/12/2025 8:44 AM
Details	State	Update	New Registration	Pending	Approved	3/12/2025 8:44 AM
Dates	Signed By Date	Update	New Registration		3/10/2025 1:35:57 PM	3/12/2025 8:44 AM
Dates	Start Date	Update	New Registration		4/1/2025 12:00:00 AM	3/12/2025 8:44 AM
Addresses	Main Address	Insert	New Registration		501 Doctor Michael Debakey Dr Lake Charles, LA 70601-5724	3/10/2025 1:35 PM
Contacts	Authorizing Official	Insert	New Registration		Ng, Jason CFO SWLA CENTER FOR HEALTH SERVICES 3374888008	3/10/2025 1:35 PM
Contacts	Primary Contact	Insert	New Registration		Duplechain-Cellum, Pamela Pharmacist SWLA Center for Health Services 3374399983	3/10/2025 1:35 PM
Details	Assistance Received From Date	Insert	New Registration			3/10/2025 1:35 PM
Details	Assistance Received To Date	Insert	New Registration			3/10/2025 1:35 PM
Details	Last Recertification Date	Insert	New Registration			3/10/2025 1:35 PM
Details	Grant Number	Insert	New Registration		H80CS00558	3/10/2025 1:35 PM
Details	340B ID	Insert	New Registration			3/10/2025 1:35 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			3/10/2025 1:35 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			3/10/2025 1:35 PM
Details	Medicare Provider Number	Insert	New Registration			3/10/2025 1:35 PM
Details	Entity Name	Insert	New Registration		SWLA CENTER FOR HEALTH SERVICES	3/10/2025 1:35 PM
Details	NOFO Number	Insert	New Registration			3/10/2025 1:35 PM
Details	Program Code	Insert	New Registration		CH	3/10/2025 1:35 PM
Details	Entity Subname	Insert	New Registration		SWLA Center for Health Services--DeBakey Drive Temporary Location	3/10/2025 1:35 PM
Dates	Participating Approval Date	Insert	New Registration			3/10/2025 1:35 PM
Details	State	Insert	New Registration		Pending	3/10/2025 1:35 PM
Dates	Registration Date	Insert	New Registration		3/10/2025 1:35:53 PM	3/10/2025 1:35 PM
Dates	Signed By Date	Insert	New Registration			3/10/2025 1:35 PM
Dates	Start Date	Insert	New Registration			3/10/2025 1:35 PM
Terminations	Termination Comments	Insert	New Registration			3/10/2025 1:35 PM
Terminations	Termination Date	Insert	New Registration			3/10/2025 1:35 PM
Terminations	Termination Effective Date	Insert	New Registration			3/10/2025 1:35 PM
Terminations	Termination Reason	Insert	New Registration			3/10/2025 1:35 PM

340B Drug Pricing Program Database