340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HEALTH MART PHARMACY OF LAFAYETTE
DSH190054 IBERIA MEDICAL CENTER
Print
Covered Entity Details
Entity Name
IBERIA MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190054
Entity Address
2315 EAST MAIN STREET
NEW IBERIA, LA 70560
Medicare Provider Number
190054
Participating Start Date
7/1/2004
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
HEALTH MART PHARMACY OF LAFAYETTE
Pharmacy Address
600 JOHNSTON ST
LAFAYETTE, LA 70501-8060
Pharmacy Comments
Contract Details
Approval Date
4/19/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/9/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Amy Langlinais, CFO
(337) 374-7104
Contract Pharmacy Representative
Health Mart of Lafayette
Kitty L Trahan, COO
(337) 230-1567
Signed By Date
4/19/2023
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