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LOUISIANA CVS PHARMACY, L.L.C.
CH062870 EXCELTH, INCORPORATED
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Covered Entity Details
Entity Name
EXCELTH, INCORPORATED
Subdivision Name
EXCELTH, INC., HEALTH CARE NETWORK
Type
HRSA-Funded Health Center
340B ID
CH062870
Entity Address
1515 Poydras St
New Orleans, LA 70112-3723
Grant Number
H80CS00129
Participating Start Date
12/1/1992
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05342
3535 SEVERN AVE
METAIRIE, LA 70002
Pharmacy Comments
Contract Details
Approval Date
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHAEL A. ANDRY, CEO
(504) 524-1210 Ext: 4123
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2022
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