340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LOUISIANA CVS PHARMACY, L.L.C.
DSH190201 CHRISTUS Lake Area Hospital
Print
Covered Entity Details
Entity Name
CHRISTUS Lake Area Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190201
Entity Address
4200 NELSON RD
LAKE CHARLES, LA 70605
Medicare Provider Number
190201
Participating Start Date
1/1/2018
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01099
4828 NELSON RD.
LAKE CHARLES, LA 70605
Pharmacy Comments
Contract Details
Approval Date
10/5/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Trevino, CEO, CHRISTUS Health Southeast Texas
(409) 899-7102
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/5/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session