Contract Pharmacy Details

WINN DIXIE PHARMACY #1432
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

WINN DIXIE PHARMACY #1432

Pharmacy Address

3300 PARIS RD
CHALMETTE, LA 70043

Pharmacy Comments

Contract Details

Approval Date

4/16/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/15/2023
Pharmacy closed

Contacts

Covered Entity Signing Official

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

Contract Pharmacy Representative

SE Grocers
Scott Wink, Director, Pharmacy Managed Care
(904) 370-7776

Signed By Date

4/16/2016

340B Drug Pricing Program Database