340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CENTERWELL PHARMACY, INC.
CAH191315-02 HARDTNER MEDICAL CENTER
Print
Covered Entity Details
Entity Name
HARDTNER MEDICAL CENTER
Subdivision Name
LASALLE PARISH HOSPITAL SERVICE DIS / HARDTNER FAMILY CLINIC
Type
Critical Access Hospital
340B ID
CAH191315-02
Entity Address
1102 NORTH PINE RD
HARDTNER MEDICAL CENTER
OLLA, LA 71465-4804
Medicare Provider Number
191315
Outpatient Facility Provider Number
193493
Participating Start Date
10/1/2016
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
CENTERWELL PHARMACY, INC.
Pharmacy Address
10737 MARKS WAY
MIRAMAR, FL 33025
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/7/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Paul G. Mathews, Administrator
(318) 495-3131 Ext: 109
Contract Pharmacy Representative
Centerwell
Shelley Duke, Director, Specialty Pharmacy Contracting and Infusion
(502) 994-8732
Signed By Date
10/15/2021
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