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CARMICHAEL CASHWAY PHARMACY
DSH190044 ACADIA GENERAL HOSPITAL
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Covered Entity Details
Entity Name
ACADIA GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190044
Entity Address
1305 CROWLEY RAYNE HWY.
CROWLEY, LA 70526
Medicare Provider Number
190044
Participating Start Date
4/1/2011
Last Recertification Date
8/27/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
CARMICHAEL CASHWAY PHARMACY
Pharmacy Address
1002 N PARKERSON AVE
CROWLEY, LA 70526-3613
Pharmacy Comments
Contract Details
Approval Date
4/1/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/19/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CHARMAINE R. VIDRINE, CFO
(337) 788-6402
Contract Pharmacy Representative
Byron D. Finn, President
(337) 783-7263
Signed By Date
4/1/2015
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