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ACCREDO HEALTH GROUP, INC.
STD705701 Acadiana Practitioners LLC
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Covered Entity Details
Entity Name
Acadiana Practitioners LLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD705701
Entity Address
1119 Prudhomme Circle
Opelousas, LA 70570
Grant Number
NH25PS005176
Participating Start Date
11/13/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
4750 E 450 S
SUITE A
WHITESTOWN, IN 46075
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rhonda Bergeron, CEO
(337) 447-4027
Contract Pharmacy Representative
Accredo
Travis Behrens, Managing Director
(314) 486-5839
Signed By Date
1/15/2025
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