340B Drug Pricing Program Database
WAL-MART PHARMACY #10-0761
STD705171 Cardiovascular Institute of the South - information as of 5/13/2025 1:49:31 AM
Covered Entity Details
Entity Name
Cardiovascular Institute of the South
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD705171
Entity Address
1451 East Bridge Street
Breaux Bridge, LA 70517
Grant Number
NH25PS005176
Participating Start Date
4/1/2025
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY #10-0761
Pharmacy Address
4858 HIGHWAY 1
RACELAND, LA 70394
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
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
4/15/2025
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session