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MISSISSIPPI CVS PHARMACY, L.L.C.
DSH190036 OCHSNER CLINIC FOUNDATION
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Covered Entity Details
Entity Name
OCHSNER CLINIC FOUNDATION
Subdivision Name
DBA OCHSNER FOUNDATION HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH190036
Entity Address
1514-1516 JEFFERSON HIGHWAY
NEW ORLEANS, LA 70121
Medicare Provider Number
190036
Participating Start Date
7/1/2006
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
MISSISSIPPI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05740
1701 A HWY 43 N
PICAYUNE, MS 39466
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott Posecai, Executive VP and Chief Financial Officer
(504) 842-4097
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2020
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