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LOUISIANA CVS PHARMACY, L.L.C.
STD700582 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
STD700582
Entity Address
1901 Manhattan Boulevard, Building A
STE 200
Harvey, LA 70058
Grant Number
NH25PS005176
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 4501
1204 ELTON RD.
JENNINGS, LA 70546
Pharmacy Comments
Contract Details
Approval Date
4/3/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ryan Hebert, CEO
(985) 873-5670
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/3/2025
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