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WALGREEN LOUISIANA CO., INC.
DSH190274 OCHSNER MEDICAL CENTER - KENNER
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Covered Entity Details
Entity Name
OCHSNER MEDICAL CENTER - KENNER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190274
Entity Address
180 WEST ESPLANADE AVE.
KENNER, LA 70065
Medicare Provider Number
190274
Participating Start Date
7/1/2008
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA: WALGREENS # 02469
220 W ESPLANADE AVE
KENNER, LA 70065-2460
Pharmacy Comments
Contract Details
Approval Date
9/1/2010
Contract Begin Date
9/1/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/2/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
7/7/2010
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