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SOILEAU'S PHARMACY
STD703013 Cardiovascular Institute of the South
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Covered Entity Details
Entity Name
Cardiovascular Institute of the South
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD703013
Entity Address
1320 Martin Luther King
Thibodaux, LA 70301
Grant Number
NH25PS005176
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
SOILEAU'S PHARMACY
Pharmacy Address
J&J RX SOLUTIONS LLC
805 CENTER ST
NEW IBERIA, LA 70560
Pharmacy Comments
Contract Details
Approval Date
2/12/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ryan Hebert, CEO
(985) 873-5670
Contract Pharmacy Representative
Soileau's Pharmacy
Tala Bui, Owner
(337) 365-6721
Signed By Date
1/14/2025
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