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LCMC HEALTH PHARMACY SERVICES, LLC
DSH190313 NEW ORLEANS EAST HOSPITAL
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Covered Entity Details
Entity Name
NEW ORLEANS EAST HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190313
Entity Address
5620 READ BOULEVARD
NEW ORLEANS, LA 70127
Medicare Provider Number
190313
Participating Start Date
7/1/2017
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
LCMC HEALTH PHARMACY SERVICES, LLC
Pharmacy Address
200 HENRY CLAY AVE STE 2107
NEW ORLEANS, LA 70118
Pharmacy Comments
Contract Details
Approval Date
1/6/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Danielle Serina Willis, Chief Financial Officer and Chief Administrative Officer
(504) 592-6610
Contract Pharmacy Representative
LCMC HEALTH PHARMACY SERVICES, LLC
ELIAS AYOUB, VP OF SPECIALTY PHARMACY
(504) 702-3188
Signed By Date
1/6/2023
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