340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS PHARMACY, INC.
DSH190013B WEST CALCASIEU-CAMERON HOSPITAL
Print
Covered Entity Details
Entity Name
WEST CALCASIEU-CAMERON HOSPITAL
Subdivision Name
W CALCASIEU CAMERON HOSP VINTON MED - Vinton Medical Clinic
Type
Disproportionate Share Hospital
340B ID
DSH190013B
Entity Address
1611 HAMPTON STREET
VINTON, LA 70668-3707
Medicare Provider Number
190013
Outpatient Facility Provider Number
193458
Participating Start Date
10/1/2018
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 06381
2425 N. 16TH ST.
ORANGE, TX 77630
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