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ACCREDO HEALTH GROUP, INC.
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
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
4750 E 450 S
SUITE A
WHITESTOWN, IN 46075
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
Accredo
Travis Behrens, Managing Director
(314) 486-5839
Signed By Date
4/9/2025
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