340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
VITAL CARE OF MISS-LOU, INC
CAH191318-00 Concordia Parish Hospital Service District 1 DBA Trinity Medical
Print
Covered Entity Details
Entity Name
Concordia Parish Hospital Service District 1 DBA Trinity Medical
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH191318-00
Entity Address
6569 Hwy 84
Ferriday, LA 71334
Medicare Provider Number
191318
Participating Start Date
10/1/2011
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
VITAL CARE OF MISS-LOU, INC
Pharmacy Address
D/B/A LAKESIDE PHARMACY & GIFT
6280 HIGHWAY 129
PO BOX 37
MONTEREY, LA 71354
Pharmacy Comments
Contract Details
Approval Date
11/15/2011
Contract Begin Date
11/15/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/21/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lana Stamper, Adminstrator
(318) 757-6551 Ext: 301
Contract Pharmacy Representative
CHARLES E. MAIER, OWNER/PHARMACIST
(318) 757-8711
Signed By Date
11/7/2011
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