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PARTNERS PHARMACY, LLC
CAH191323-00 Hospital Service District 1A, Parish of Richland, State of Louisiana, DBA Richland Parish Hospital
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Covered Entity Details
Entity Name
Hospital Service District 1A, Parish of Richland, State of Louisiana, DBA Richland Parish Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH191323-00
Entity Address
407 Cincinnati Street
Delhi, LA 71232-3008
Medicare Provider Number
191323
Participating Start Date
7/1/2014
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
PARTNERS PHARMACY, LLC
Pharmacy Address
3915 KIRKMAN ST
LAKE CHARLES, LA 70607-3503
Pharmacy Comments
Contract Details
Approval Date
10/9/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael Carroll, CEO
(318) 878-6323
Contract Pharmacy Representative
Partners Pharmacy, LLC
Rick Delrie, Managing Officer
(337) 853-1438
Signed By Date
10/9/2017
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