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ACCREDO HEALTH GROUP, INC.
STD70380 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
STD70380
Entity Address
113 Picone Road
Houma, LA 70363
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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