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KEN'S THRIFTY WAY PHARMACY
STD705704 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
STD705704
Entity Address
1200 Hospital Drive STE 4
Opelousas, LA 70570
Grant Number
NH25PS005176
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
KEN'S THRIFTY WAY PHARMACY
Pharmacy Address
AND HOME MEDICAL-PORT BARRE
418 N SAIZON ST
PORT BARRE, LA 70577-5156
Pharmacy Comments
Contract Details
Approval Date
5/2/2025
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
Ken's Thrifty Way
Tammy Robert, Manager
(337) 942-8911
Signed By Date
4/9/2025
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