340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LIFE TREE PHARMACY BROUSSARD
STD70518 Merakey Pennsylvania-Broussard
Print
Covered Entity Details
Entity Name
Merakey Pennsylvania-Broussard
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD70518
Entity Address
120 Park Center Dr
Broussard, LA 70518
Grant Number
6 NH25PS005176-02-03
Participating Start Date
1/1/2021
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
LIFE TREE PHARMACY BROUSSARD
Pharmacy Address
120 PARK CENTER DR
BROUSSARD, LA 70518-3605
Pharmacy Comments
Contract Details
Approval Date
11/9/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph S Martz, CEO
(215) 341-9395
Contract Pharmacy Representative
Life Tree Pharmacy
Mark Taglianetti, CEO
(610) 489-6640
Signed By Date
10/15/2020
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