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LOUISIANA CVS PHARMACY, L.L.C.
DSH190019 CHRISTUS ST FRANCES CABRINI HOSPITAL
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Covered Entity Details
Entity Name
CHRISTUS ST FRANCES CABRINI HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190019
Entity Address
3330 MASONIC DRIVE
ALEXANDRIA, LA 71301
Medicare Provider Number
190019
Participating Start Date
4/1/2006
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05544
100 EDGEWOOD DR.
PINEVILLE, LA 71360
Pharmacy Comments
Contract Details
Approval Date
7/6/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John P Shaughnessy, CFO
(318) 528-3550
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/6/2022
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