Contract Pharmacy Details

O'DONOVAN PHARMACY
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

O'DONOVAN PHARMACY

Pharmacy Address

5131 ODONOVAN DR STE 402
BATON ROUGE, LA 70808-4792

Pharmacy Comments

6/27/2013 - OPA request to add DEA number.

Contract Details

Approval Date

4/5/2013

Contract Begin Date

4/14/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2019
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

HEATHER WEAVER, TAB COORDINATOR
(504) 568-5489

Contract Pharmacy Representative

Our Lady of the Lake
Jeffrey Limbocker, CFO
(225) 765-8550

Signed By Date

4/1/2013

340B Drug Pricing Program Database