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SCOTT'S PHARMACY
DSH190015 North Oaks Medical Center LLC
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Covered Entity Details
Entity Name
North Oaks Medical Center LLC
Subdivision Name
DBA NORTH OAKS MEDICAL CENTER LLC
Type
Disproportionate Share Hospital
340B ID
DSH190015
Entity Address
15790 PAUL VEGA M.D. DRIVE
HAMMOND, LA 70403
Medicare Provider Number
190015
Participating Start Date
4/1/2005
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
SCOTT'S PHARMACY
Pharmacy Address
42242 VETERANS AVE
HAMMOND, LA 70403
Pharmacy Comments
Contract Details
Approval Date
10/2/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/31/2021
Ownership change
Contacts
Covered Entity Signing Official
Mark T Anderson, CFO
(985) 230-6602
Contract Pharmacy Representative
Scott's Pharmacy
Scott Forrest, Owner
(985) 542-7230
Signed By Date
10/2/2019
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