Contract Pharmacy Details

LOUISIANA CVS PHARMACY, L.L.C.
CH061335A ST. CHARLES COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

ST. CHARLES COMMUNITY HEALTH CENTER, INC.

Subdivision Name

ST. CHARLES COMMUNITY HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH061335A

Entity Address

843 Milling Ave
Luling, LA 70070-4442

Grant Number

H80CS00867

Participating Start Date

10/1/2003

Last Recertification Date

2/26/2025

Pharmacy Details

Pharmacy Name

LOUISIANA CVS PHARMACY, L.L.C.

Pharmacy Address

CVS/PHARMACY # 10538
5000 NORTH CLAIBORNE AVE.
NEW ORLEANS, LA 70117

Pharmacy Comments

Contract Details

Approval Date

2/14/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/12/2020
Pharmacy closed

Contacts

Covered Entity Signing Official

MARK F. KEISER, CEO
(504) 575-3746

Contract Pharmacy Representative

CVS
Lisa Chaykowski, National Sales Executive
(214) 918-6261

Signed By Date

2/14/2020

340B Drug Pricing Program Database