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CHRISTUS SPECIALTY PHARMACY
DSH190019 CHRISTUS ST FRANCES CABRINI HOSPITAL
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Covered Entity Details
Entity Name
CHRISTUS ST FRANCES CABRINI HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190019
Entity Address
3330 MASONIC DRIVE
ALEXANDRIA, LA 71301
Medicare Provider Number
190019
Participating Start Date
4/1/2006
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
CHRISTUS SPECIALTY PHARMACY
Pharmacy Address
MOTHER FRANCES REGIONAL HEALTH CARE CTR
800 E DAWSON ST STE 100
TYLER, TX 75701-2036
Pharmacy Comments
Contract Details
Approval Date
6/4/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John P Shaughnessy, CFO
(318) 528-3550
Contract Pharmacy Representative
CHRISTUS Health
Justin Simon, Corporate Director of Pharmacy - Business Services
(214) 704-9531
Signed By Date
6/4/2021
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