Contract Pharmacy Details

AFFORDABLE 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

AFFORDABLE PHARMACY

Pharmacy Address

1718 NORTH FOSTER DR
BATON ROUGE, LA 70806

Pharmacy Comments

Contract Details

Approval Date

1/13/2014

Contract Begin Date

4/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

HEATHER WEAVER, TAB COORDINATOR
(504) 568-5489

Contract Pharmacy Representative

Rogers Cooper, PIC and Owner
(225) 771-8194

Signed By Date

1/13/2014