340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ALBERTSONS LLC
CAH191302-00 ST. MARTIN HOSPITAL
Print
Covered Entity Details
Entity Name
ST. MARTIN HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH191302-00
Entity Address
210 CHAMPAGNE BLVD.
BREAUX BRIDGE, LA 70517
Medicare Provider Number
191302
Participating Start Date
9/28/2010
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
ALBERTSONS LLC
Pharmacy Address
SAV-ON PHARMACY #719
4400 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508
Pharmacy Comments
Contract Details
Approval Date
7/10/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Glenn Dailey, CEO
(337) 507-1201
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
7/10/2020
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