340B Drug Pricing Program Database
WAL-MART PHARMACY 10-5722
STD700582 Cardiovascular Institute of the South - information as of 5/7/2025 11:34:05 PM
Covered Entity Details
Entity Name
Cardiovascular Institute of the South
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD700582
Entity Address
1901 Manhattan Boulevard, Building A
STE 200
Harvey, LA 70058
Grant Number
NH25PS005176
Participating Start Date
4/1/2025
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5722
Pharmacy Address
3265 MANHATTAN BLVD.
HARVEY, LA 70058
Pharmacy Comments
Contract Details
Approval Date
4/14/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ryan Hebert, CEO
(985) 873-5670
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
4/14/2025
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