340B Drug Pricing Program Database
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Walmart Pharmacy 10-7611
Acadiana Practitioners' Specialty Clinic
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Covered Entity Details
Entity Name
Acadiana Practitioners' Specialty Clinic
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
Entity Address
1200 Hospital Drive STE 4
Opelousas, LA 70570
Grant Number
NH25PS005176
Participating Start Date
Last Recertification Date
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rhonda Bergeron, CEO
(337) 447-4027
Contract Pharmacy Representative
Walmart
Nick Tallman, Sr. Director, Merchandise Operations – Pharmacy
(479) 371-0417
Signed By Date
4/9/2025
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