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LOUISIANA CVS PHARMACY, L.L.C.
DSH190005 University Medical Center Management Corporation d/b/a University Medical Center New Orleans
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Covered Entity Details
Entity Name
University Medical Center Management Corporation d/b/a University Medical Center New Orleans
Subdivision Name
UMCNO
Type
Disproportionate Share Hospital
340B ID
DSH190005
Entity Address
2000 Canal Street
NEW ORLEANS, LA 70112
Medicare Provider Number
190005
Participating Start Date
1/1/1997
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05288
1500 W AIRLINE HWY
LA PLACE, LA 70068
Pharmacy Comments
Contract Details
Approval Date
4/11/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christine M Bond, CFO
(504) 702-4380
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/11/2025
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