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LOUISIANA CVS PHARMACY, L.L.C.
DSH190176 University Healthcare System.L.C. d/b/a East Jefferson General Hospital
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Covered Entity Details
Entity Name
University Healthcare System.L.C. d/b/a East Jefferson General Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190176
Entity Address
4200 Houma Blvd.
Metairie, LA 70006
Medicare Provider Number
190176
Participating Start Date
4/1/2023
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
LOUISIANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 167
4401 S CLAIBORNE AVE.
NEW ORLEANS, LA 70125
Pharmacy Comments
Contract Details
Approval Date
4/14/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bradley Scott Sinclair, CFO
(504) 962-6048
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2025
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