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OCHSNER PHARMACY AND WELLNESS LLC
CAH191324-00 OCHSNER BAYOU LLC
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Covered Entity Details
Entity Name
OCHSNER BAYOU LLC
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH191324-00
Entity Address
4608 HIGHWAY 1
RACELAND, LA 70394
Medicare Provider Number
191324
Participating Start Date
1/1/2016
Last Recertification Date
8/29/2024
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
4/4/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Juan Awad, Chief Executive Officer
(985) 537-2656
Contract Pharmacy Representative
Ochsner Pharmacy
Richard Ricky Indovina Jr., Director of Reatail Pharmacy Operations
(504) 842-5623
Signed By Date
4/4/2022
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