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NEW IBERIA MEDICINE SHOPPE, INC
CH062350 IBERIA COMPRHESIVE COM HEALTH CNTR, INC.
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Covered Entity Details
Entity Name
IBERIA COMPRHESIVE COM HEALTH CNTR, INC.
Subdivision Name
IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH062350
Entity Address
806 Jefferson Ter
New Iberia, LA 70560-5727
Grant Number
H80CS00697
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
NEW IBERIA MEDICINE SHOPPE, INC
Pharmacy Address
DELAUNE'S PHARMACY & HOME MEDICAL
308 N LEWIS ST
NEW IBERIA, LA 70563-2843
Pharmacy Comments
Contract Details
Approval Date
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RODERICK C. CAMPBELL, CEO
(337) 365-4945 Ext: 128
Contract Pharmacy Representative
Delaunes Pharmacy
Andrea Bourque, Pharmacist In Charge
(337) 364-7671
Signed By Date
1/12/2024
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