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COMMUNITY HEALTH PHARMACY
DSH190125 ST FRANCIS MEDICAL CENTER, INC
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Covered Entity Details
Entity Name
ST FRANCIS MEDICAL CENTER, INC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190125
Entity Address
309 JACKSON STREET
MONROE, LA 71201
Medicare Provider Number
190125
Participating Start Date
4/1/2006
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
COMMUNITY HEALTH PHARMACY
Pharmacy Address
2600 TOWER DRIVE
SUITE 102
MONROE, LA 71201
Pharmacy Comments
Contract Details
Approval Date
8/2/2012
Contract Begin Date
8/2/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/16/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ronald E. Hogan, CFO/Sr. VP
(318) 966-4794
Contract Pharmacy Representative
Ronald E. Hogan, CFO/Sr. VP
(318) 966-4794
Signed By Date
7/23/2012
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