340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CENTERWELL PHARMACY, INC.
CAH191304-02 NORTH CADDO MEDICAL CENTER
Print
Covered Entity Details
Entity Name
NORTH CADDO MEDICAL CENTER
Subdivision Name
NCMC MEDICAL AND SURGICAL CLINIC
Type
Critical Access Hospital
340B ID
CAH191304-02
Entity Address
815 South Pine
VIVIAN, LA 71082-3351
Medicare Provider Number
191304
Outpatient Facility Provider Number
193476
Participating Start Date
7/1/2016
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
CENTERWELL PHARMACY, INC.
Pharmacy Address
10737 MARKS WAY
MIRAMAR, FL 33025
Pharmacy Comments
Contract Details
Approval Date
1/11/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Jones, CEO
(318) 375-4001
Contract Pharmacy Representative
Centerwell
Shelley Duke, Director, Specialty Pharmacy Contracting and Infusion
(502) 994-8732
Signed By Date
1/11/2021
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