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OCHSNER PHARMACY AND WELLNESS LLC
DSH190202 OCHSNER MEDICAL CENTER- BATON ROUGE, LLC
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Covered Entity Details
Entity Name
OCHSNER MEDICAL CENTER- BATON ROUGE, LLC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190202
Entity Address
17000 MEDICAL CENTER DR.
BATON ROUGE, LA 70816
Medicare Provider Number
190202
Participating Start Date
7/1/2010
Last Recertification Date
8/28/2024
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
Dianne Teal, Chief Nursing officer
(225) 755-4983
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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