Contract Pharmacy Details

PARISH PHARMACY INC
RWIID70112 STD/HIV Program

Covered Entity Details

Entity Name

STD/HIV Program

Subdivision Name

OFFICE OF PUBLIC HEALTH

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID70112

Entity Address

1450 POYDRAS ST.
Suite 2136
NEW ORLEANS, LA 70112

Grant Number

X07HA00018

Participating Start Date

7/1/1998

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

PARISH PHARMACY INC

Pharmacy Address

DBA KINGS PHARMACY
3102 LINWOOD AVE
SHREVEPORT, LA 71103

Pharmacy Comments

Contract Details

Approval Date

4/11/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Samuel Burgess, STD/HIV/Hepatitis Program Director
(504) 568-7474

Contract Pharmacy Representative

Kings Pharmacy
Daniel Hayek, Manager
(318) 635-8159

Signed By Date

4/11/2022

340B Drug Pricing Program Database