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MANSFIELD DRUG CO, INC
CHC26579-05 C A S S E Dental Health Institute
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Covered Entity Details
Entity Name
C A S S E Dental Health Institute
Subdivision Name
CASSE - DIAMC Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26579-05
Entity Address
1560 Irving Pl
Shreveport, LA 71101-4604
Grant Number
H80CS26579
Participating Start Date
4/1/2021
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
MANSFIELD DRUG CO, INC
Pharmacy Address
132 JEFFERSON ST
MANSFIELD, LA 71052-2602
Pharmacy Comments
Contract Details
Approval Date
4/25/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Beth Chumley, CEO
(318) 688-3350
Contract Pharmacy Representative
CASSE Dental Health Institute
Tisha M Dennis, Contract & Coordinator of Operations
(318) 688-3350
Signed By Date
4/25/2025
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