340B Drug Pricing Program Database
LOUISIANA CVS PHARMACY, L.L.C.
DSH190045 ST. TAMMANY PARISH HOSPITAL - information as of 6/13/2025 3:55:20 PM
Covered Entity Details
Entity Name
ST. TAMMANY PARISH HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190045
Entity Address
St. Tammany Parish Hospital
1202 S. Tyler Street
COVINGTON, LA 70433
Medicare Provider Number
190045
Participating Start Date
10/1/2018
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05614
627 W 21ST AVE
COVINGTON, LA 70433
Pharmacy Comments
Contract Details
Approval Date
1/14/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sandra DiPietro, Senior Vice President/Chief Financial Officer
(985) 898-4583
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/14/2021
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