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NRMC PHARMACY ALLIANCE, LLC
DSH190007 NATCHITOCHES REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
NATCHITOCHES REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190007
Entity Address
501 KEYSER AVENUE
NATCHITOCHES, LA 71457
Medicare Provider Number
190007
Participating Start Date
10/1/2022
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
NRMC PHARMACY ALLIANCE, LLC
Pharmacy Address
NRMC OUTPATIENT PHARMACY
601 KEYSER AVE
STE A
NATCHITOCHES, LA 71457
Pharmacy Comments
Contract Details
Approval Date
9/14/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Damian K. Soileau, CEO
(318) 214-4512
Contract Pharmacy Representative
NRMC OP Pharmacy
Stephen Stricklin, Pharmacy Manager
(318) 214-4259
Signed By Date
7/14/2022
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