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K & B LOUISIANA CORPORATION
CH062350 IBERIA COMPRHESIVE COM HEALTH CNTR, INC.
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Covered Entity Details
Entity Name
IBERIA COMPRHESIVE COM HEALTH CNTR, INC.
Subdivision Name
IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH062350
Entity Address
806 Jefferson Ter
New Iberia, LA 70560-5727
Grant Number
H80CS00697
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
K & B LOUISIANA CORPORATION
Pharmacy Address
RITE AID #7304
1150 WEST ST. PETER STREET
NEW IBERIA, LA 70560
Pharmacy Comments
Contract Details
Approval Date
10/15/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/22/2018
Ownership change
Contacts
Covered Entity Signing Official
RODERICK C. CAMPBELL, CEO
(337) 365-4945 Ext: 128
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
10/15/2013
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