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ACCREDO HEALTH GROUP, INC.
DSH190011 BRFHH Monroe LLC d/b/a Ochsner LSU Health Monroe
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Covered Entity Details
Entity Name
BRFHH Monroe LLC d/b/a Ochsner LSU Health Monroe
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190011
Entity Address
4864 JACKSON STREET
MONROE, LA 71202
Medicare Provider Number
190011
Participating Start Date
1/1/1998
Last Recertification Date
8/29/2024
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
7/15/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Larry Donner, CEO
(318) 330-7525
Contract Pharmacy Representative
Accredo
Ann Campagna, PIC
(302) 395-8937
Signed By Date
7/15/2015
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