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OCHSNER PHARMACY AND WELLNESS LLC
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
OCHSNER PHARMACY AND WELLNESS LLC
Pharmacy Address
DBA OCHSNER SPECIALTY PHARMACY - BATON R
11200 INDUSTRIPLEX BLVD STE 160
BATON ROUGE, LA 70809
Pharmacy Comments
Contract Details
Approval Date
1/14/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peter C November, EVP, CFO
(504) 842-1335
Contract Pharmacy Representative
Ochsner Pharmacy
Richard Ricky Indovina Jr., Director of Reatail Pharmacy Operations
(504) 842-5623
Signed By Date
1/14/2022
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