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LAGNIAPPE PHARMACY 7, LLC
STD700723 Harris M. Blackman, MD, LLC
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Covered Entity Details
Entity Name
Harris M. Blackman, MD, LLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD700723
Entity Address
1111 Medical Center Boulevard
N-401
Marrero, LA 70072
Grant Number
NH25PS005176
Participating Start Date
4/1/2023
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
LAGNIAPPE PHARMACY 7, LLC
Pharmacy Address
1900 SAINT CHARLES AVE
NEW ORLEANS, LA 70130-5317
Pharmacy Comments
Contract Details
Approval Date
5/31/2023
Contract Begin Date
6/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/23/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jennifer Ladd Bowman, Office Manager
(504) 347-2141 Ext: 1
Contract Pharmacy Representative
Lagniappe Pharmacy
Steve Charbonnet, Owner
(504) 669-3870
Signed By Date
5/31/2023
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