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GEM DRUGS GRAMERCY INC
CAH191305-00 ST. JAMES PARISH HOSPITAL
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Covered Entity Details
Entity Name
ST. JAMES PARISH HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH191305-00
Entity Address
1645 LUTCHER AVENUE
LUTCHER, LA 70071
Medicare Provider Number
191305
Participating Start Date
9/9/2010
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
GEM DRUGS GRAMERCY INC
Pharmacy Address
1635 HIGHWAY 3125
GRAMERCY, LA 70052-3554
Pharmacy Comments
Contract Details
Approval Date
7/22/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/30/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MARY ELLEN PRATT, CEO
(225) 746-2990
Contract Pharmacy Representative
Gem Drugs
Randy Mire, President
(225) 869-3651
Signed By Date
7/22/2013
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