Contract Pharmacy Details

LALLIE KEMP REGIONAL MED CTR
RWIID70112 STD/HIV Program

Covered Entity Details

Entity Name

STD/HIV Program

Subdivision Name

OFFICE OF PUBLIC HEALTH

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID70112

Entity Address

1450 POYDRAS ST.
Suite 2136
NEW ORLEANS, LA 70112

Grant Number

X07HA00018

Participating Start Date

7/1/1998

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

LALLIE KEMP REGIONAL MED CTR

Pharmacy Address

LALLIE KEMP REGIONAL MEDICAL CENTER
52579 HIGHWAY 51 S
INDEPENDENCE, LA 70443-2231

Pharmacy Comments

Contract Details

Approval Date

4/6/2011

Contract Begin Date

4/6/2011

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

3/21/2011

340B Drug Pricing Program Database