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LOUISIANA CVS PHARMACY, L.L.C.
DSH190005 University Medical Center Management Corporation d/b/a University Medical Center New Orleans
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Covered Entity Details
Entity Name
University Medical Center Management Corporation d/b/a University Medical Center New Orleans
Subdivision Name
UMCNO
Type
Disproportionate Share Hospital
340B ID
DSH190005
Entity Address
2000 Canal Street
NEW ORLEANS, LA 70112
Medicare Provider Number
190005
Participating Start Date
1/1/1997
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 2597
2600 PARIS RD
CHALMETTE, LA 70043
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/13/2025
Agreement registered in error
Contacts
Covered Entity Signing Official
Christine M Bond, CFO
(504) 702-4380
Contract Pharmacy Representative
Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118
Signed By Date
10/15/2024
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