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WAL-MART PHARMACY 10-1102
CAH191306-00 WEST FELICIANA PARISH HOSPITAL
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Covered Entity Details
Entity Name
WEST FELICIANA PARISH HOSPITAL
Subdivision Name
A POLITICAL SUBDIVISION OF THE PARISH OF WEST FELICIANA PARISH
Type
Critical Access Hospital
340B ID
CAH191306-00
Entity Address
5266 COMMERCE STREET
SAINT FRANCISVILLE, LA 70775
Medicare Provider Number
191306
Participating Start Date
10/1/2018
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1102
Pharmacy Address
14507 PLANK ROAD
BAKER, LA 70714
Pharmacy Comments
Contract Details
Approval Date
4/18/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ledoux Chastant, CEO
(225) 635-2441
Contract Pharmacy Representative
Walmart
Christian Nava, Senior Manager, Program Development-340B
(210) 632-0647
Signed By Date
4/18/2025
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