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OCHSNER OUTPATIENT AND HOME INFUSION PHA
DSH190036 OCHSNER CLINIC FOUNDATION
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Covered Entity Details
Entity Name
OCHSNER CLINIC FOUNDATION
Subdivision Name
DBA OCHSNER FOUNDATION HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH190036
Entity Address
1514-1516 JEFFERSON HIGHWAY
NEW ORLEANS, LA 70121
Medicare Provider Number
190036
Participating Start Date
7/1/2006
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
OCHSNER OUTPATIENT AND HOME INFUSION PHA
Pharmacy Address
4115 JEFFERSON HWY
NEW ORLEANS, LA 70121
Pharmacy Comments
Contract Details
Approval Date
7/10/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott Posecai, Executive VP and Chief Financial Officer
(504) 842-4097
Contract Pharmacy Representative
Ochsner Outpatient and Home Infusion L.L.C.
Gena Territo-Tynes, Director Ochsner Outpatient and Home Infusion Pharmacy
(504) 703-2808
Signed By Date
7/10/2019
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