340B Drug Pricing Program Database
WALMART PHARMACY 10-7396
STD70563 Cardiovascular Institute of the South - information as of 4/30/2025 12:02:20 AM
Covered Entity Details
Entity Name
Cardiovascular Institute of the South
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD70563
Entity Address
500 N. Lewis Street
STE 100
New Iberia, LA 70563
Grant Number
NH25PS005176
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-7396
Pharmacy Address
16759 HIGHWAY 3235
GILLIANO, LA 70345
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