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ACCREDO HEALTH GROUP, INC.
STD703602 South Louisiana Medical Associates
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Covered Entity Details
Entity Name
South Louisiana Medical Associates
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD703602
Entity Address
605 Enterprise Drive Suite B
HOUMA, LA 70360
Grant Number
NU62PS924522
Participating Start Date
5/3/2022
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
2 BOULDEN CIR STE 1
NEW CASTLE, DE 19720-3492
Pharmacy Comments
Contract Details
Approval Date
10/2/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Wendy Rotolo, Business office manager
(985) 209-8547
Contract Pharmacy Representative
Accredo
Travis Behrens, Managing Director
(314) 486-5839
Signed By Date
10/2/2024
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