Contract Pharmacy Details

LOUISIANA CVS PHARMACY, L.L.C.
DSH190036 OCHSNER CLINIC FOUNDATION

Covered Entity Details

Entity Name

OCHSNER CLINIC FOUNDATION

Subdivision Name

DBA OCHSNER FOUNDATION HOSPITAL

Type

Disproportionate Share Hospital

340B ID

DSH190036

Entity Address

1514-1516 JEFFERSON HIGHWAY
NEW ORLEANS, LA 70121

Medicare Provider Number

190036

Participating Start Date

7/1/2006

Last Recertification Date

9/4/2024

Pharmacy Details

Pharmacy Name

LOUISIANA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 05441
4301 AIRLINE DRIVE
METAIRIE, LA 70001

Pharmacy Comments

Contract Details

Approval Date

7/11/2013

Contract Begin Date

10/1/2013

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Scott Posecai, Executive VP and Chief Financial Officer
(504) 842-4097

Contract Pharmacy Representative

CVS
Scott Tierney, Senior Director, Payer Relations
(401) 770-2762

Signed By Date

7/11/2013

340B Drug Pricing Program Database