340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LOUISIANA CVS PHARMACY, L.L.C.
DSH190013 WEST CALCASIEU-CAMERON HOSPITAL
Print
Covered Entity Details
Entity Name
WEST CALCASIEU-CAMERON HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190013
Entity Address
701 EAST CYPRESS
SULPHUR, LA 70663
Medicare Provider Number
190013
Participating Start Date
10/1/2018
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05455
1269 SAM HOUSTON JONES PKWY
LAKE CHARLES, LA 70611
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jobie James, Chief Financial Officer
(337) 527-4143
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session