340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BROTHER'S PHARMACY
STD704033 Northlake Gastroenterology Associates, LLP
Print
Covered Entity Details
Entity Name
Northlake Gastroenterology Associates, LLP
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD704033
Entity Address
16061 Doctors Blvd.
Suite B
Hammond, LA 70403
Grant Number
NH25PS005176
Participating Start Date
10/1/2024
Last Recertification Date
5/9/2025
Pharmacy Details
Pharmacy Name
BROTHER'S PHARMACY
Pharmacy Address
BROTHER'S PHARMACY LLC
6200 LESLIE LN
LAKE CHARLES, LA 70615
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
11/12/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Martin Leahy, Manager
(985) 542-1334
Contract Pharmacy Representative
Pharmacy
Troy Tate, President
(800) 291-1089
Signed By Date
10/15/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session