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LOUISIANA CVS PHARMACY, L.L.C.
CH063380 SWLA CENTER FOR HEALTH SERVICES
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Covered Entity Details
Entity Name
SWLA CENTER FOR HEALTH SERVICES
Subdivision Name
SOUTHWEST LOUISIANA CENTER FOR HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH063380
Entity Address
2000 Opelousas St
Lake Charles, LA 70601-2641
Grant Number
H80CS00558
Participating Start Date
10/1/2002
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05554
111 WESTGATE RD.
LAFAYETTE, LA 70506
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jason Ng, CFO
(337) 488-8008
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/13/2020
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