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WAL-MART PHARMACY 10-0543
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
WAL-MART PHARMACY 10-0543
Pharmacy Address
1629 EAST CRESSWELL LANE
OPELOUSAS, LA 70570
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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