Covered Entity Details

CH04608C CENTRAL MISSISSIPPI HEALTH SERVICES, INC. (Active) - information as of 6/27/2025 12:25:39 AM

Main Details

Name

CENTRAL MISSISSIPPI HEALTH SERVICES, INC.

Subdivision Name

CENTRAL MISSISSIPPI HEALTH SERVICES, INC - HIGHWAY 80

Type

HRSA-Funded Health Center

Site ID

BPS-H80-028009

340B ID

CH04608C

Grant Number

H80CS00860

Additional Details

Current Program Status

Active

Registration Date

10/14/2022

Participating Start Date

1/1/2023

Participating Approval Date

10/17/2022

Last Recertification Date

3/4/2025

Contacts

Authorizing Official

Central Mississippi Health Services, Inc.
Robert Smith, MD
(601) 948-5572

Primary Contact

Central Mississippi Health Services
Shynettia Wesley, Revenue Cycle Manager
(601) 948-5572 Ext: 1653

Addresses

Street Address

3450 Highway 80 West , Ste, 70, 71 &72 BLDG
Jackson, MS 39209-7201

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH046080	Active	BPS-H80-004065	CENTRAL MISSISSIPPI HEALTH SERVICES, INC.	CENTRAL MISSISSIPPI HEALTH SERVICES, INC.	1134 Winter St	Jackson	MS
CH04608A	Active	BPS-H80-001489	CENTRAL MISSISSIPPI HEALTH SERVICES, INC.	CENTRAL MS HLTH SVS - TOUGALOO	500 W COUNTY LINE RD	JACKSON	MS
CH04608B	Active	BPS-H80-000378	CENTRAL MISSISSIPPI HEALTH SERVICES, INC.	CENTRAL MISSISSIPPI HLTH SERVICE	5429 Robinson Road Ext	Jackson	MS
CH04608C	Active	BPS-H80-028009	CENTRAL MISSISSIPPI HEALTH SERVICES, INC.	CENTRAL MISSISSIPPI HEALTH SERVICES, INC - HIGHWAY 80	3450 Highway 80 West , Ste, 70, 71 &72 BLDG	Jackson	MS

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH046080	AVITA PHARMACY 1037	AVITA DRUGS LLC-NOLA D/B/A AVITA PHARMAC	2519 CANAL ST	NEW ORLEANS	LA	70119	04/01/2018
CH046080	AVITA PHARMACY 1038	AVITA DRUGS LLC-NOLA 2 D/B/A AVITA PHARM	3308 TULANE AVE STE 102	NEW ORLEANS	LA	70119-7170	04/01/2018
CH046080	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	04/01/2018
CH046080	AVITA PHARMACY 1043	AVITA DRUGS MISSISSIPPI LLC D/B/A AVITA	805 E RIVER PL STE A	JACKSON	MS	39202-3486	01/01/2020
CH046080	CURANT HEALTH FLORIDA, LLC	11001 ROOSEVELT BLVD N STE 1400		ST PETERSBURG	FL	33716	05/04/2022
CH04608A	CURANT HEALTH FLORIDA, LLC	11001 ROOSEVELT BLVD N STE 1400		ST PETERSBURG	FL	33716	07/01/2022
CH04608B	CURANT HEALTH FLORIDA, LLC	11001 ROOSEVELT BLVD N STE 1400		ST PETERSBURG	FL	33716	07/01/2022
CH046080	CURANT HEALTH GEORGIA LLC	CURANT HEALTH	200 TECHNOLOGY CT SE BLDG 200 SUITE B	SMYRNA	GA	30082-5250	05/04/2022
CH04608A	CURANT HEALTH GEORGIA LLC	CURANT HEALTH	200 TECHNOLOGY CT SE BLDG 200 SUITE B	SMYRNA	GA	30082-5250	07/01/2022
CH04608B	CURANT HEALTH GEORGIA LLC	CURANT HEALTH	200 TECHNOLOGY CT SE BLDG 200 SUITE B	SMYRNA	GA	30082-5250	07/01/2022
CH046080	FREDS PHARMACY #1996	540 RAYMOND RD		JACKSON	MS	39204-3600	11/27/2009	04/05/2019
CH046080	HARCO INC.	RITE AID #7405	380 WEST WOODROW WILSON AVENUE	JACKSON	MS	39213	10/01/2013	01/16/2018
CH046080	KROGER FOOD & PHARMACY #345	4910 I-55 N		JACKSON	MS	39211	07/01/2019
CH046080	LOUISIANA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05354	1624 N. BURNSIDE	GONZALES	LA	70737	07/01/2022
CH04608A	LOUISIANA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05354	1624 N. BURNSIDE	GONZALES	LA	70737	07/01/2022
CH04608B	LOUISIANA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05354	1624 N. BURNSIDE	GONZALES	LA	70737	07/01/2022
CH046080	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04997	305 MEADOWBROOK RD.	JACKSON	MS	39206	10/01/2019
CH046080	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05745	2803 SUNCREST DR	JACKSON	MS	39212	10/01/2019
CH046080	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05756	1420 CANTON MART RD.	JACKSON	MS	39211	10/01/2019
CH046080	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04993	1014 HIGHWAY 51	MADISON	MS	39110	07/01/2022
CH046080	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05876	914 N STATE ST	JACKSON	MS	39202	07/01/2022
CH046080	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 08311	4899 LAKELAND DR.	FLOWOOD	MS	39232	07/01/2022
CH046080	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10020	801 HWY 80 E	CLINTON	MS	39056	07/01/2022
CH04608A	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04993	1014 HIGHWAY 51	MADISON	MS	39110	07/01/2022
CH04608A	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05876	914 N STATE ST	JACKSON	MS	39202	07/01/2022
CH04608A	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 08311	4899 LAKELAND DR.	FLOWOOD	MS	39232	07/01/2022
CH04608A	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10020	801 HWY 80 E	CLINTON	MS	39056	07/01/2022
CH04608A	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05745	2803 SUNCREST DR	JACKSON	MS	39212	07/01/2022
CH04608A	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05756	1420 CANTON MART RD.	JACKSON	MS	39211	07/01/2022
CH04608B	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05876	914 N STATE ST	JACKSON	MS	39202	07/01/2022
CH04608B	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04993	1014 HIGHWAY 51	MADISON	MS	39110	07/01/2022
CH04608B	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 08311	4899 LAKELAND DR.	FLOWOOD	MS	39232	07/01/2022
CH04608B	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10020	801 HWY 80 E	CLINTON	MS	39056	07/01/2022
CH04608B	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04997	305 MEADOWBROOK RD.	JACKSON	MS	39206	07/01/2022
CH04608B	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05745	2803 SUNCREST DR	JACKSON	MS	39212	07/01/2022
CH04608B	MISSISSIPPI CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05756	1420 CANTON MART RD.	JACKSON	MS	39211	07/01/2022
CH046080	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2019
CH046080	WAL-MART PHARMACY 10-0875	815 S WHEATLEY RD		RIDGELAND	MS	39157	07/01/2019
CH046080	WAL-MART PHARMACY 10-0903	2711 GREENWAY DRIVE		JACKSON	MS	39204	04/01/2015
CH046080	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2019
CH046080	WALGREEN CO	DBA: WALGREENS #10694	5780 TERRY RD	BYRAM	MS	39272	09/09/2011
CH046080	WALGREEN CO	DBA: NISSAN FAMILY PHARMACY	300 NISSAN DRIVE	CANTON	MS	39046	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS # 04191	3445 TERRY ROAD	JACKSON	MS	39212	09/09/2011	05/20/2020
CH046080	WALGREEN CO.	DBA: WALGREENS # 03918	3189 HWY 80 EAST	PEARL	MS	39208	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS #16089	310 MEADOWBROOK ROAD	JACKSON	MS	39206	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS #15485	1583 EAST COUNTY LINE ROAD	JACKSON	MS	39211	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS # 05098	955 N STATE ST	JACKSON	MS	39202	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS # 05165	204 HIGHWAY 80 EAST	CLINTON	MS	39056	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS # 05655	6970 OLD CANTON ROAD	RIDGELAND	MS	39157	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS # 05791	1497 CANTON MART RD	JACKSON	MS	39211	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS # 07184	2896 MCDOWELL ROAD EXTENSION	JACKSON	MS	39204-4238	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS # 07517	977 ELLIS AVENUE	JACKSON	MS	39209-6256	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS # 07656	1199 HWY 49 SOUTH	RICHLAND	MS	39218-4425	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS # 10270	1000 HUGH WARD BLVD	FLOWOOD	MS	39232	09/09/2011
CH046080	WALGREEN CO.	DBA: WALGREENS #11111	1100 HWY 51	MADISON	MS	39110	09/09/2011
CH046080	WALGREEN CO.	WALGREENS #19297	380 W WOODROW WILSON AVE	JACKSON	MS	39213	02/16/2018	07/06/2023
CH046080	WALGREEN CO.	WALGREENS #21165	971 LAKELAND DRIVE SUITE 101	JACKSON	MS	39216	07/01/2019
CH046080	WALMART PHARMACY 10-6469	131 HANDLEY BLVD		BYRAM	MS	39272	07/01/2019

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	1/30/2024 10:27:16 AM	3/4/2025 12:35:36 PM	3/4/2025 12:35 PM
Details	Last Recertification Date	Update	Recertification	2/13/2023 12:09:57 PM	1/30/2024 10:27:16 AM	1/30/2024 10:27 AM
Details	Last Recertification Date	Update	Recertification		2/13/2023 12:09:57 PM	2/13/2023 12:09 PM
Details	State	Update		Approved	Active	1/1/2023 12:01 AM
Contacts	Signed By	Insert	New Registration		Smith, Robert MD Central Mississippi Health Services, Inc. 6019485572	10/17/2022 10:39 AM
Details	340B ID	Update	New Registration		CH04608C	10/17/2022 10:39 AM
Dates	Participating Approval Date	Update	New Registration		10/17/2022 10:39:57 AM	10/17/2022 10:39 AM
Details	State	Update	New Registration	Pending	Approved	10/17/2022 10:39 AM
Dates	Signed By Date	Update	New Registration		10/14/2022 12:36:34 PM	10/17/2022 10:39 AM
Dates	Start Date	Update	New Registration		1/1/2023 12:00:00 AM	10/17/2022 10:39 AM
Addresses	Main Address	Insert	New Registration		3450 Highway 80 West , Ste, 70, 71 &72 BLDG Jackson, MS 39209-7201	10/14/2022 11:16 AM
Contacts	Authorizing Official	Insert	New Registration		Smith, Robert MD Central Mississippi Health Services, Inc. 6019485572	10/14/2022 11:16 AM
Contacts	Primary Contact	Insert	New Registration		Wesley, Shynettia Revenue Cycle Manager Central Mississippi Health Services 6019485572-1653	10/14/2022 11:16 AM
Details	Assistance Received From Date	Insert	New Registration			10/14/2022 11:16 AM
Details	Assistance Received To Date	Insert	New Registration			10/14/2022 11:16 AM
Details	Last Recertification Date	Insert	New Registration			10/14/2022 11:16 AM
Details	Grant Number	Insert	New Registration		H80CS00860	10/14/2022 11:16 AM
Details	340B ID	Insert	New Registration			10/14/2022 11:16 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/14/2022 11:16 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/14/2022 11:16 AM
Details	Medicare Provider Number	Insert	New Registration			10/14/2022 11:16 AM
Details	Entity Name	Insert	New Registration		CENTRAL MISSISSIPPI HEALTH SERVICES, INC.	10/14/2022 11:16 AM
Details	NOFO Number	Insert	New Registration			10/14/2022 11:16 AM
Details	Program Code	Insert	New Registration		CH	10/14/2022 11:16 AM
Details	Entity Subname	Insert	New Registration		CENTRAL MISSISSIPPI HEALTH SERVICES, INC - HIGHWAY 80	10/14/2022 11:16 AM
Dates	Participating Approval Date	Insert	New Registration			10/14/2022 11:16 AM
Details	State	Insert	New Registration		Pending	10/14/2022 11:16 AM
Dates	Registration Date	Insert	New Registration		10/14/2022 11:16:24 AM	10/14/2022 11:16 AM
Dates	Signed By Date	Insert	New Registration			10/14/2022 11:16 AM
Dates	Start Date	Insert	New Registration			10/14/2022 11:16 AM
Terminations	Termination Comments	Insert	New Registration			10/14/2022 11:16 AM
Terminations	Termination Date	Insert	New Registration			10/14/2022 11:16 AM
Terminations	Termination Effective Date	Insert	New Registration			10/14/2022 11:16 AM
Terminations	Termination Reason	Insert	New Registration			10/14/2022 11:16 AM

340B Drug Pricing Program Database