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PERKINS' FAMILY PHARMACY, LLC
STD712633 West Carroll Medical Clinic
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Covered Entity Details
Entity Name
West Carroll Medical Clinic
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD712633
Entity Address
502 Ross Street
Oak Grove, LA 71263
Grant Number
NH25PS005176
Participating Start Date
10/1/2024
Last Recertification Date
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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