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OCHSNER PHARMACY AND WELLNESS LLC
DSH190079 ST CHARLES PARISH HOSPITAL
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Covered Entity Details
Entity Name
ST CHARLES PARISH HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190079
Entity Address
1057 PAUL MAILLARD ROAD
LULING, LA 70070
Medicare Provider Number
190079
Participating Start Date
4/1/2018
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
OCHSNER PHARMACY AND WELLNESS LLC
Pharmacy Address
DBA - OCHSNER PHARMACY AND WELLNESS - DE
13100 RIVER RD STE 110
DESTREHAN, LA 70047-5216
Pharmacy Comments
Contract Details
Approval Date
1/14/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tara E Alleman, CFO
(985) 785-3726
Contract Pharmacy Representative
OPW Destrehan
Dana Patterson, Pharmacist in Charge
(985) 898-7220
Signed By Date
1/14/2020
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