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LOUISIANA CVS PHARMACY, L.L.C.
DSH190202 OCHSNER MEDICAL CENTER- BATON ROUGE, LLC
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Covered Entity Details
Entity Name
OCHSNER MEDICAL CENTER- BATON ROUGE, LLC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190202
Entity Address
17000 MEDICAL CENTER DR.
BATON ROUGE, LA 70816
Medicare Provider Number
190202
Participating Start Date
7/1/2010
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 17559
2030 HAMMOND SQUARE DR
HAMMOND, LA 70403
Pharmacy Comments
Contract Details
Approval Date
10/17/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dianne Teal, Chief Nursing officer
(225) 755-4983
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/17/2023
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