340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS PHARMACY, INC.
CAH191325-00 LAFOURCHE HOSPITAL SERVICE DISTRICT #1 DBA LADY OF THE SEA GENERAL HOSPITAL
Print
Covered Entity Details
Entity Name
LAFOURCHE HOSPITAL SERVICE DISTRICT #1 DBA LADY OF THE SEA GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH191325-00
Entity Address
200 WEST 134TH PLACE
CUT OFF, LA 70345
Medicare Provider Number
191325
Participating Start Date
9/14/2010
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
225 HARPERS LANDING BLVD
CONROE, TX 77385
Pharmacy Comments
Contract Details
Approval Date
10/13/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/24/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Karen S. Collins, C.E.O.
(985) 632-8286
Contract Pharmacy Representative
CVS Rx Services, Inc
Jordan Birnbaum, 340B Vendor Manager
(401) 770-2241
Signed By Date
10/13/2014
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session