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ACCREDO HEALTH GROUP INC
DSH190007 NATCHITOCHES REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
NATCHITOCHES REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190007
Entity Address
501 KEYSER AVENUE
NATCHITOCHES, LA 71457
Medicare Provider Number
190007
Participating Start Date
10/1/2022
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
520 ELMWOOD PARK BLVD STE 100
NEW ORLEANS, LA 70123-6826
Pharmacy Comments
Contract Details
Approval Date
1/8/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Damian K. Soileau, CEO
(318) 214-4512
Contract Pharmacy Representative
Accredo Health Group
Ricky L Thompson, Account Executive
(314) 569-4388
Signed By Date
1/8/2025
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