Covered Entity Details

CHC28962-04 H I V/ A I D S Alliance For Region Two Inc (Active) - information as of 5/25/2025 1:18:25 AM

Main Details

Name

H I V/ A I D S Alliance For Region Two Inc

Subdivision Name

OHCC - 30789 Range Avenue

Type

HRSA-Funded Health Center

Site ID

BPS-H80-031316

340B ID

CHC28962-04

Grant Number

H80CS28962

Additional Details

Current Program Status

Active

Registration Date

11/10/2020

Participating Start Date

1/1/2021

Participating Approval Date

11/16/2020

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

HIV-Aids Alliance for Region Two, Inc.
Lyndon Darensbourg, CFO
(225) 424-1734

Primary Contact

HAART
Timothy Young, CEO
(225) 424-1800

Addresses

Street Address

30789 N Range Ave
Denham Springs, LA 70726

Billing Address

HIV/AIDS Alliance for Region Two, Inc
9516 AIRLINE HWY
BATON ROUGE, LA 70815

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
CHC28962-00	Active	BPS-H80-018650	HIV/AIDS ALLIANCE FOR REGION TWO, INC.	North Blvd Clinic	3801 North Blvd.	BATON ROUGE	LA
CHC28962-01	Terminated	BPS-H80-027446	H I V/ A I D S Alliance For Region Two Inc	Capital Area Human Services District	4615 Government St Ste 112	Baton Rouge	LA
CHC28962-02	Active	BPS-H80-030279	H I V/ A I D S Alliance For Region Two Inc	HAART Clinic	3849 North Blvd	Baton Rouge	LA
CHC28962-03	Terminated	BPS-H80-030838	H I V/ A I D S Alliance For Region Two Inc	CAHSD - Wooddale	2751 Wooddale Blvd	Baton Rouge	LA
CHC28962-04	Active	BPS-H80-031316	H I V/ A I D S Alliance For Region Two Inc	OHCC - 30789 Range Avenue	30789 N Range Ave	Denham Springs	LA
CHC28962-05	Active	BPS-H80-032761	HIV/AIDS Alliance For Region Two (HAART), Inc.	Mobile Unit #1	9516 AIRLINE HWY	Baton Rouge	LA
CHC28962-06	Active	BPS-H80-034126	HIV/AIDS Alliance For Region Two (HAART), Inc.	OHCC Baranco-Clark	1735 Thomas H Delpit Dr	Baton Rouge	LA
CHC28962-07	Active	BPS-H80-034524	HIV/AIDS Alliance For Region Two (HAART), Inc.	OHCC - Colonial	781 Colonial Dr	Baton Rouge	LA
CHC28962-08	Active	BPS-H80-033724	HIV/AIDS ALLIANCE FOR REGION TWO (HAART), INC.	OHHC Dental	3905 Convention St	Baton Rouge	LA
CHC28962-09	Active	BPS-H80-036388	HIV/AIDS ALLIANCE FOR REGION TWO (HAART), INC.	OHCC - Airline North	9516 Airline Hwy	Baton Rouge	LA
CHC28962-10	Active	BPS-H80-038005	HIV/AIDS ALLIANCE FOR REGION TWO (HAART), INC.	Capitol Middle School	5100 Greenwell Springs Rd. # AB	Baton Rouge	LA
CHC28962-11	Active	BPS-H80-038256	HIV/AIDS ALLIANCE FOR REGION TWO (HAART), INC.	Jefferson Terrace Academy	5601 Upton Dr. RM D117	Baton Rouge	LA
CHC28962-12	Active	BPS-H80-038333	HIV/AIDS ALLIANCE FOR REGION TWO (HAART), INC.	Claiborne Elementary School	4707 Denham St. RM C205	Baton Rouge	LA
CHC28962-13	Active	BPS-H80-018181	HIV/AIDS ALLIANCE FOR REGION TWO (HAART), INC.	Homeless Drop-In Center	153 N. 17th St. RM 162	Baton Rouge	LA
CHC28962-14	Active	BPS-H80-038975	HIV/AIDS ALLIANCE FOR REGION TWO (HAART), INC.	Progress Elementary School	855 Progress Rd RM 148	Baton Rouge	LA
CHC28962-15	Approved	BPS-H80-039563	HIV/AIDS ALLIANCE FOR REGION TWO (HAART), INC.	Mobile Dental Clinic	9516 Airline Hwy	Baton Rouge	LA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date
CHC28962-00	AVITA PHARMACY 1028	340B PARTNERS PHARMACY-DALLAS LLC DBA AV	750 FORT WORTH AVE STE H100	DALLAS	TX	75208-1811	07/01/2016
CHC28962-00	AVITA PHARMACY 1037	AVITA DRUGS LLC-NOLA D/B/A AVITA PHARMAC	2519 CANAL ST	NEW ORLEANS	LA	70119	07/01/2016
CHC28962-00	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	07/01/2016
CHC28962-00	RELIANT HEALTHCARE	RELIANT MEDICAL LLC	4315 TEXAS BLVD	TEXARKANA	TX	75503	07/01/2019
CHC28962-00	RELIANT MEDICAL LLC DBA RELIANT HEALTHCA	1004 N 19TH ST		MONROE	LA	71201-5734	07/01/2019
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 02995	3550 GOVERNMENT ST	BATON ROUGE	LA	70806	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 02980	4747 S SHERWOOD FOREST	BATON ROUGE	LA	70816	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 02982	5450 PLANK ROAD	BATON ROUGE	LA	70805	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 02996	11297 FLORIDA BLVD	BATON ROUGE	LA	70815	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03399	7620 JEFFERSON HIGHWAY	BATON ROUGE	LA	70809	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03047	5112 ESSEN LANE	BATON ROUGE	LA	70809	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03610	12881 PERKINS RD.	BATON ROUGE	LA	70810	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 06028	9820 OLD HAMMOND HWY	BATON ROUGE	LA	70816	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 07440	2001 ONEAL LANE	BATON ROUGE	LA	70816-3204	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 06448	4485 PERKINS ROAD	BATON ROUGE	LA	70808-3034	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 07836	3671 JOOR ROAD	BATON ROUGE	LA	70814-3104	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 07083	9983 BLUEBONNET BLVD	BATON ROUGE	LA	70810	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 09860	5955 AIRLINE HWY	BATON ROUGE	LA	70805-3202	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #09518	15929 AIRLINE HWY	BATON ROUGE	LA	70817	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03180	101 FLORIDA AVE. SE	DENHAM SPRINGS	LA	70726	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 11498	5061 MAIN STREET	ZACHARY	LA	70791	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 07795	6515 SULLIVAN RD	GREENWELL SPRINGS	LA	70739-3110	07/01/2016
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA WALGREENS SPECIALTY PHARMACY #16478	5555 ESSEN LN STE C	BATON ROUGE	LA	70809	04/01/2017
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 03085	14444 COURSEY BLVD.	BATON ROUGE	LA	70817	07/01/2017
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA:WALGREENS #15366	220 N ALEXANDER AVE	PORT ALLEN	LA	70767-2514	07/01/2017
CHC28962-00	WALGREEN LOUISIANA CO., INC.	WALGREENS #17647	2159 STARING LN	BATON ROUGE	LA	70810-1038	07/01/2019
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #13925	5298 HIGHLAND RD.	BATON ROUGE	LA	70808-6530	07/01/2020
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #11762	10200 FLORIDA BLVD	WALKER	LA	70785	04/01/2022
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS # 10400	34865 LA HWY 16	DENHAM SPRINGS	LA	70706-0669	04/01/2022
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #13080	3081 S. RANGE AVE	DENHAM SPRINGS	LA	70726	04/01/2022
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA:WALGREENS #13779	39527 HWY 42	PRAIRIEVILLE	LA	70769	04/01/2022
CHC28962-00	WALGREEN LOUISIANA CO., INC.	DBA: WALGREENS #13875	6485 GROOM RD	BAKER	LA	70714	04/01/2022
CHC28962-00	WALGREEN LOUISIANA CO., INC.	WALGREENS #17423	2152 S SHERWOOD FOREST BLVD	BATON ROUGE	LA	70816-8327	04/01/2022
CHC28962-00	Walgreens #21373	Walgreens Central Fill #21373	4100 Dale Earnhardt Way STE 200	Northlake	TX	76262	10/01/2023

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	1/29/2024 8:15:31 AM	2/10/2025 8:50:33 AM	2/10/2025 8:50 AM
Addresses	Billing Address	Update	Recertification	HIV/AIDS Alliance for Region Two, Inc 4550 North Blvd Ste 250 Baton Rouge, LA 70806	HIV/AIDS Alliance for Region Two, Inc 9516 AIRLINE HWY BATON ROUGE, LA 70815	1/29/2024 8:15 AM
Details	Last Recertification Date	Update	Recertification	1/30/2023 9:14:53 AM	1/29/2024 8:15:31 AM	1/29/2024 8:15 AM
Details	Last Recertification Date	Update	Recertification	1/31/2022 9:01:32 AM	1/30/2023 9:14:53 AM	1/30/2023 9:14 AM
Details	Last Recertification Date	Update	Recertification	2/18/2021 5:06:28 PM	1/31/2022 9:01:32 AM	1/31/2022 9:01 AM
Contacts	Primary Contact	Update	Change Request	Darensbourg, Lyndon CFO HIV-Aids Alliance for Region Two, Inc. 2254241734	Young, Timothy CEO HAART 2254241800	1/13/2022 7:17 AM
Contacts	Authorizing Official	Update	Change Request	Young, Timothy CEO HAART 2254241800	Darensbourg, Lyndon CFO HIV-Aids Alliance for Region Two, Inc. 2254241734	1/13/2022 7:17 AM
Contacts	Primary Contact	Update	Recertification	Darensbourg, Lyndon Chief Financial Officer HIV/AIDS Alliance for Region Two, Inc. 2254241734	Darensbourg, Lyndon CFO HIV-Aids Alliance for Region Two, Inc. 2254241734	2/18/2021 5:06 PM
Details	Last Recertification Date	Update	Recertification		2/18/2021 5:06:28 PM	2/18/2021 5:06 PM
Contacts	Primary Contact	Update	Change Request	DeLany, Denise Compliance Manager HIV/AIDS Alliance for Region Two, Inc. 2254241813	Darensbourg, Lyndon Chief Financial Officer HIV/AIDS Alliance for Region Two, Inc. 2254241734	1/6/2021 1:59 PM
Details	State	Update		Approved	Active	1/1/2021 12:01 AM
Contacts	Signed By	Insert	New Registration		Young, Timothy CEO HAART 2254241800	11/16/2020 8:02 AM
Details	340B ID	Update	New Registration		CHC28962-04	11/16/2020 8:02 AM
Dates	Participating Approval Date	Update	New Registration		11/16/2020 8:02:24 AM	11/16/2020 8:02 AM
Details	State	Update	New Registration	Pending	Approved	11/16/2020 8:02 AM
Dates	Signed By Date	Update	New Registration		11/10/2020 2:05:34 PM	11/16/2020 8:02 AM
Dates	Start Date	Update	New Registration		1/1/2021 12:00:00 AM	11/16/2020 8:02 AM
Addresses	Main Address	Insert	New Registration		30789 N Range Ave Denham Springs, LA 70726	11/10/2020 11:23 AM
Addresses	Billing Address	Insert	New Registration		HIV/AIDS Alliance for Region Two, Inc 4550 North Blvd Ste 250 Baton Rouge, LA 70806	11/10/2020 11:23 AM
Contacts	Authorizing Official	Insert	New Registration		Young, Timothy CEO HAART 2254241800	11/10/2020 11:23 AM
Contacts	Primary Contact	Insert	New Registration		DeLany, Denise Compliance Manager HIV/AIDS Alliance for Region Two, Inc. 2254241813	11/10/2020 11:23 AM
Details	Assistance Received From Date	Insert	New Registration			11/10/2020 11:23 AM
Details	Assistance Received To Date	Insert	New Registration			11/10/2020 11:23 AM
Details	Last Recertification Date	Insert	New Registration			11/10/2020 11:23 AM
Details	Grant Number	Insert	New Registration		H80CS28962	11/10/2020 11:23 AM
Details	340B ID	Insert	New Registration			11/10/2020 11:23 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			11/10/2020 11:23 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			11/10/2020 11:23 AM
Details	Medicare Provider Number	Insert	New Registration			11/10/2020 11:23 AM
Details	Entity Name	Insert	New Registration		H I V/ A I D S Alliance For Region Two Inc	11/10/2020 11:23 AM
Details	NOFO Number	Insert	New Registration			11/10/2020 11:23 AM
Details	Program Code	Insert	New Registration		CH	11/10/2020 11:23 AM
Details	Entity Subname	Insert	New Registration		OHCC - 30789 Range Avenue	11/10/2020 11:23 AM
Dates	Participating Approval Date	Insert	New Registration			11/10/2020 11:23 AM
Details	State	Insert	New Registration		Pending	11/10/2020 11:23 AM
Dates	Registration Date	Insert	New Registration		11/10/2020 11:23:21 AM	11/10/2020 11:23 AM
Dates	Signed By Date	Insert	New Registration			11/10/2020 11:23 AM
Dates	Start Date	Insert	New Registration			11/10/2020 11:23 AM
Terminations	Termination Comments	Insert	New Registration			11/10/2020 11:23 AM
Terminations	Termination Date	Insert	New Registration			11/10/2020 11:23 AM
Terminations	Termination Effective Date	Insert	New Registration			11/10/2020 11:23 AM
Terminations	Termination Reason	Insert	New Registration			11/10/2020 11:23 AM

340B Drug Pricing Program Database