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LOUISIANA CVS PHARMACY, L.L.C.
CAH191324-00 OCHSNER BAYOU LLC
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Covered Entity Details
Entity Name
OCHSNER BAYOU LLC
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH191324-00
Entity Address
4608 HIGHWAY 1
RACELAND, LA 70394
Medicare Provider Number
191324
Participating Start Date
1/1/2016
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
CVS/PHARMACY # 10885
1420 ST. CHARLES STREET
HOUMA, LA 70360
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Erika Anderson, CFO - Bayou Region
(985) 850-2370
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/11/2023
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