Contract Pharmacy Details

LOUISIANA CVS PHARMACY, L.L.C.
CHC24198-00 Marillac Community Health Centers

Covered Entity Details

Entity Name

Marillac Community Health Centers

Subdivision Name

DCHC-Carrollton

Type

HRSA-Funded Health Center

340B ID

CHC24198-00

Entity Address

3201 S. Carrollton Ave.
New Orleans, LA 70118-4307

Grant Number

H80CS24198

Participating Start Date

10/1/2012

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

LOUISIANA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05528
1313 PAUL MAILLARD RD/PO BOX 50
LULING, LA 70070

Pharmacy Comments

Contract Details

Approval Date

1/14/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/20/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

Michael Griffin, President and CEO
(504) 212-9502

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

1/14/2020

340B Drug Pricing Program Database