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RAINA RX LLC
STD705081 Acadiana Allergy Asthma and Immunology Center d/b/a Lafayette Allergies
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Covered Entity Details
Entity Name
Acadiana Allergy Asthma and Immunology Center d/b/a Lafayette Allergies
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD705081
Entity Address
101 Rue Fontaine Building 2
Lafayette, LA 70508
Grant Number
NH25PS005176
Participating Start Date
12/18/2024
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
RAINA RX LLC
Pharmacy Address
DBA ROUTE 300 PHARMACY
1208 ROUTE 300
SUITE 103
NEWBURGH, NY 12550
Pharmacy Comments
Contract Details
Approval Date
4/1/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Chelsey Escoyne, Practice Manager
(337) 484-1414
Contract Pharmacy Representative
BioPlus
Jeremy Richardson, Vice President of Strategy & Commercial Growth
(317) 730-7705
Signed By Date
4/1/2025
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