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PERKINS' FAMILY PHARMACY, LLC
STD712631 Community Medical Clinic
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Covered Entity Details
Entity Name
Community Medical Clinic
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD712631
Entity Address
712 Settoon Street
Oak Grove, LA 71263
Grant Number
NH25PS005176
Participating Start Date
10/1/2024
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
PERKINS' FAMILY PHARMACY, LLC
Pharmacy Address
803 E MAIN ST
OAK GROVE, LA 71263-2534
Pharmacy Comments
Contract Details
Approval Date
8/7/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amanda D Grey, COO
(318) 428-3237
Contract Pharmacy Representative
Mer Rouge Family Pharmacy, LLC dba Perkins Family Pharmacy
Laura Beth Perkins, Owner
(318) 669-0901
Signed By Date
7/15/2024
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