340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALMART PHARMACY 10-6590
DSH190133 ALLEN PARISH HOSPITAL
Print
Covered Entity Details
Entity Name
ALLEN PARISH HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190133
Entity Address
108 6th Ave
KINDER, LA 70648
Medicare Provider Number
190133
Participating Start Date
10/1/2017
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WALMART PHARMACY 10-6590
Pharmacy Address
260 SAM HOUSTON JONES PKWY
LAKE CHARLES, LA 70611
Pharmacy Comments
Contract Details
Approval Date
10/13/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jacqueline Reviel, Allen Parish Hospital CEO
(337) 738-9479
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
10/13/2017
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