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OCHSNER SPECIALTY PHARMACY
DSH190008 Hospital Service District No. 1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System
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Covered Entity Details
Entity Name
Hospital Service District No. 1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190008
Entity Address
8166 MAIN STREET
HOUMA, LA 70360
Medicare Provider Number
190008
Participating Start Date
10/1/2007
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
OCHSNER SPECIALTY PHARMACY
Pharmacy Address
1405 JEFFERSON HWY
SUITE A
NEW ORLEANS, LA 70121
Pharmacy Comments
Contract Details
Approval Date
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
FRANCES DIANE YEATES, COO
(985) 873-4605
Contract Pharmacy Representative
Ochsner Pharmacy
Richard Ricky Indovina Jr., Director of Reatail Pharmacy Operations
(504) 842-5623
Signed By Date
7/14/2021
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