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LOUISIANA CVS PHARMACY, L.L.C.
HV12908 NO/AIDS TASK FORCE
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Covered Entity Details
Entity Name
NO/AIDS TASK FORCE
Subdivision Name
CrescentCare - St. Roch
Type
Ryan White Part C
340B ID
HV12908
Entity Address
1631 ELYSIAN FIELDS AVE
NEW ORLEANS, LA 70117
Grant Number
H76HA12908
Participating Start Date
1/1/2013
Last Recertification Date
3/7/2025
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05333
2242 WILLIAMS BLVD.,
KENNER, LA 70062
Pharmacy Comments
Contract Details
Approval Date
10/18/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
NOEL John TWILBECK, CEO
(504) 821-2601 Ext: 1000
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/18/2022
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