340B Drug Pricing Program Database


CH04272A EAST CENTRAL MISSISSIPPI HEALTH CARE, INC. (Active) - information as of 6/6/2025 12:35:14 PM

Main Details
EAST CENTRAL MISSISSIPPI HEALTH CARE, INC.
WALNUT GROVE MEDICAL CLINIC
HRSA-Funded Health Center
BPS-H80-003773
CH04272A
H80CS00431


Additional Details
Active
7/1/2002
7/1/2002
9/3/2004
2/13/2025

Contacts

East Central MS Health Care, Inc.
JILL BISHOP, CEO
(601) 625-7140

East Central MS Health Care, Inc.
Vivian Partain, Finance Director
(601) 625-7140

Addresses

199 RIMMER STREET
WALNUT GROVE, MS 39189

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
CORRECTED ENTITY NAME, NEW FAX NUMBER, NEW CONTACT09/03/2004
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
MS09013670,09010024,09014178,001705311699721209,1255387619,1679529028,1184090482
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailWALGREEN CO.DBA: WALGREENS # 10067 1005 W BEACON ST
PHILADELPHIAMS39350-320303/29/202303/29/2023  03/29/2023
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH042720ActiveBPS-H80-002864EAST CENTRAL MISSISSIPPI HEALTH CARE, INC. 1490 HIGHWAY 487 SEBASTOPOLMS
CH04272AActiveBPS-H80-003773EAST CENTRAL MISSISSIPPI HEALTH CARE, INC.WALNUT GROVE MEDICAL CLINIC199 RIMMER STREET WALNUT GROVEMS
CH04272BActiveBPS-H80-000422EAST CENTRAL MISSISSIPPI HEALTH CARE INCSEBASTOPOL CLINIC1488 Highway 487 SebastopolMS
CH04272DActiveBPS-H80-000810EAST CENTRAL MISSISSIPPI HEALTH CARE INCPHILADELPHIA HEALTH CENTER10330 ROAD 375 PHILADELPHIAMS
CH04272EActiveBPS-H80-017712EAST CENTRAL MISSISSIPPI HEALTH CARE INCNewton Health Care9431 Eastside Drive Extension, Suite E NewtonMS
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH042720AHSSHCEXPEDIEN RX PHARMACY 5050 WESLEY RD STE 120
APOPKAFL3271201/01/2020 01/31/2025
CH042720AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291101/01/2020 01/31/2025
CH042720AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503401/01/2020 01/31/2025
CH042720CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503301/01/2023  
CH042720FRED'S PHARMACY237 WOODLAND DR
FORESTMS39074-352901/01/2017 01/09/2020
CH042720FRED'S PHARMACY714 PECAN AVENUNE
PHILADELPHIAMS3935001/01/2017 01/09/2020
CH042720FRED'S PHARMACY #1221300 S PEARL ST
CARTHAGEMS39051-410801/01/2017 01/09/2020
CH042720FREDS PHARMACY #2431304 NORTHSIDE DR
NEWTONMS39345-237801/01/2017 09/24/2019
CH042720FREDS XPRESS 3921801 E JACKSON RD
UNIONMS39365-221301/01/2017 01/09/2020
CH042720HOSPITAL DISCOUNT DRUGS919 HOLLAND AVE
PHILADELPHIAMS3935001/01/2017 06/13/2023
CH042720M.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312601/01/2020 01/31/2025
CH042720MOORE'S PHARMACY811 HIGHWAY 16 E
CARTHAGEMS3905110/01/2016  
CH042720MOORE'S PHARMACY16831 HWY 21 SOUTH P.O. BOX 289
SEBASTOPOLMS3935910/01/2016  
CH042720MOORE'S PHARMACY103 CHADWICK AVE E
WALNUT GROVEMS3918910/01/2016  
CH04272BMOORE'S PHARMACY103 CHADWICK AVE E
WALNUT GROVEMS3918903/29/2023  
CH042720PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310101/01/2020 01/31/2025
CH042720QUINN'S FAMILY PHARMACY24944 HIGHWAY 15
UNIONMS39365-858710/01/2019  
CH04272DQUINN'S FAMILY PHARMACY24944 HIGHWAY 15
UNIONMS39365-858703/29/2023  
CH042720QUINN'S PHARMACY NEWTON193 NORTHSIDE DR
NEWTONMS3934503/29/2023  
CH042720SCPG MISSISSIPPI LLC DBA: EXPRESS RX OF801 E JACKSON RD
UNIONMS3936510/01/2020 07/12/2024
CH042720SUPER D DRUGS ACQUISITION CO.D/B/A CARTHAGE DISCOUNT DRUG #15737 POWE 602 HWY 16 E
CARTHAGEMS3905104/01/2014 12/05/2024
CH042720SUPER D DRUGS ACQUISITION CO.CHARLIE MCCOOL'S PHARMACY #15744, POWERE 109 WEST MAIN STREET
LOUISVILLEMS3933904/01/2014 02/21/2023
CH042720WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2017  
CH042720WAL-MART PHARMACY 10-02051002 BEACON ST
PHILADELPHIAMS3935010/01/2016  
CH04272EWAL-MART PHARMACY 10-02051002 BEACON ST
PHILADELPHIAMS3935003/29/2023  
CH042720WAL-MART PHARMACY 10-0305905 HIGHWAY 16 WEST
CARTHAGEMS3905110/01/2019  
CH042720WAL-MART PHARMACY 10-10591309 HWY 35 SO
FORESTMS3907410/01/2016  
CH042720WAL-MART PHARMACY 10-1069231 EASTSIDE DRIVE
NEWTONMS3934510/01/2019  
CH042720WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2017  
CH042720WALGREEN CO.DBA: WALGREENS #15485 1583 EAST COUNTY LINE ROAD
JACKSONMS3921104/01/2013  
CH042720WALGREEN CO.DBA: WALGREENS # 05791 1497 CANTON MART RD
JACKSONMS3921104/01/2013  
CH042720WALGREEN CO.DBA: WALGREENS # 10067 1005 W BEACON ST
PHILADELPHIAMS39350-320304/01/2013  
CH042720WALGREEN CO.DBA: WALGREENS #12536 219 WOODLAND DRIVE NORTH
FORESTMS3907404/01/2013  
CH042720WALGREEN CO.DBA: WALGREENS # 07580 1415 24TH AVE
MERIDIANMS39301-393007/01/2016  
CH042720WALGREEN CO.DBA: WALGREENS #12537 4910 POPLAR SPRINGS DR
MERIDIANMS3930507/01/2016  
CH04272AWALGREEN CO.DBA: WALGREENS # 10067 1005 W BEACON ST
PHILADELPHIAMS39350-320303/29/2023  
CH042720Walgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101 		MemphisTN3811807/01/2025  
CH042720WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818801/01/2023  
CH042720WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/01/2023  
CH042720WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/01/2023  
CH042720Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616804/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification1/31/2024 10:52:55 AM2/13/2025 2:23:37 PM2/13/2025 2:23 PM
DetailsLast Recertification DateUpdateRecertification1/31/2023 8:30:49 AM1/31/2024 10:52:55 AM1/31/2024 10:52 AM
DetailsLast Recertification DateUpdateRecertification2/18/2022 8:33:06 AM1/31/2023 8:30:49 AM1/31/2023 8:30 AM
DetailsLast Recertification DateUpdateRecertification2/5/2021 2:50:23 PM2/18/2022 8:33:06 AM2/18/2022 8:33 AM
Medicaid BillingNPI: NumberDeleteRecertification1255387619 ( ) 2/5/2021 2:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1699721209 ( ) 2/5/2021 2:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1679529028 ( ) 2/5/2021 2:50 PM
Medicaid BillingNPI: NumberDeleteRecertification1184090482 ( ) 2/5/2021 2:50 PM
Medicaid BillingNPI: NumberInsertRecertification 16997212092/5/2021 2:50 PM
Medicaid BillingNPI: StateInsertRecertification MS2/5/2021 2:50 PM
Medicaid BillingNPI: NumberInsertRecertification 12553876192/5/2021 2:50 PM
Medicaid BillingNPI: StateInsertRecertification MS2/5/2021 2:50 PM
Medicaid BillingNPI: NumberInsertRecertification 16795290282/5/2021 2:50 PM
Medicaid BillingNPI: StateInsertRecertification MS2/5/2021 2:50 PM
Medicaid BillingNPI: NumberInsertRecertification 11840904822/5/2021 2:50 PM
Medicaid BillingNPI: StateInsertRecertification MS2/5/2021 2:50 PM
ContactsPrimary ContactUpdateRecertificationHardin, Marsha Finance Director East Central MS Health Care, Inc. 6016257140Partain, Vivian Finance Director East Central MS Health Care, Inc. 60162571402/5/2021 2:50 PM
DetailsLast Recertification DateUpdateRecertification1/29/2020 3:35:36 PM2/5/2021 2:50:23 PM2/5/2021 2:50 PM
DetailsLast Recertification DateUpdateRecertification1/31/2019 11:52:31 AM1/29/2020 3:35:36 PM1/29/2020 3:35 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/26/2019 10:58 AM
Medicaid BillingMedicaid: NumberInsertChange Request 090136706/26/2019 10:58 AM
Medicaid BillingMedicaid: StateInsertChange Request MS6/26/2019 10:58 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/26/2019 10:58 AM
Medicaid BillingMedicaid: NumberInsertChange Request 090100246/26/2019 10:58 AM
Medicaid BillingMedicaid: StateInsertChange Request MS6/26/2019 10:58 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/26/2019 10:58 AM
Medicaid BillingMedicaid: NumberInsertChange Request 090141786/26/2019 10:58 AM
Medicaid BillingMedicaid: StateInsertChange Request MS6/26/2019 10:58 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False6/26/2019 10:58 AM
Medicaid BillingMedicaid: NumberInsertChange Request 001705316/26/2019 10:58 AM
Medicaid BillingMedicaid: StateInsertChange Request MS6/26/2019 10:58 AM
Medicaid BillingNPI: NumberInsertChange Request 12553876196/26/2019 10:58 AM
Medicaid BillingNPI: NumberInsertChange Request 16997212096/26/2019 10:58 AM
Medicaid BillingNPI: NumberInsertChange Request 16795290286/26/2019 10:58 AM
Medicaid BillingNPI: NumberInsertChange Request 11840904826/26/2019 10:58 AM
DetailsLast Recertification DateUpdateRecertification2/8/2018 10:59:00 AM1/31/2019 11:52:31 AM1/31/2019 11:52 AM
ContactsPrimary ContactUpdateRecertificationBISHOP, JILL CEO East Central MS Health Care, Inc. 6016257140Hardin, Marsha Finance Director East Central MS Health Care, Inc. 60162571402/8/2018 10:59 AM
DetailsLast Recertification DateUpdateRecertification1/25/2017 12:00:00 AM2/8/2018 10:59:00 AM2/8/2018 10:59 AM
ContactsAuthorizing OfficialUpdate BISHOP, JILL CEO 6016257140BISHOP, JILL CEO East Central MS Health Care, Inc. 60162571401/9/2018 2:30 PM
ContactsPrimary ContactUpdate BISHOP, JILL CEO 6016257140BISHOP, JILL CEO East Central MS Health Care, Inc. 60162571401/9/2018 2:30 PM
ContactsAuthorizing OfficialInsert  BISHOP, JILL CEO 60162571407/13/2017 12:16 PM
ContactsPrimary ContactInsert  BISHOP, JILL CEO 60162571407/13/2017 12:16 PM
AddressesMain AddressInsert   199 RIMMER STREET WALNUT GROVE, MS 391891/25/2017 1:35 PM
DetailsLast Recertification DateUpdate 2/12/2016 12:00:00 AM1/25/2017 12:00:00 AM1/25/2017 1:35 PM
DetailsLast Recertification DateUpdate 2/3/2015 12:00:00 AM2/12/2016 12:00:00 AM2/12/2016 10:50 AM
DetailsLast Recertification DateUpdate 2/10/2014 12:00:00 AM2/3/2015 12:00:00 AM2/3/2015 12:45 PM
DatesParticipating Approval DateUpdate 9/3/2004 9:09:36 AM9/3/2004 12:00:00 AM3/24/2014 10:45 AM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM2/10/2014 12:00:00 AM2/10/2014 11:47 AM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM2/6/2013 9:55 AM
DetailsLast Recertification DateInsert   9/3/2004 9:09 AM
DetailsGrant NumberInsert  H80CS004319/3/2004 9:09 AM
Details340B IDInsert  CH04272A9/3/2004 9:09 AM
DetailsIs Authorizing Official EHB DataInsert   9/3/2004 9:09 AM
DatesLast Date That 340B Drugs PurchasedInsert   9/3/2004 9:09 AM
DetailsMedicare Provider NumberInsert   9/3/2004 9:09 AM
DetailsEntity NameInsert  EAST CENTRAL MISSISSIPPI HEALTH CARE, INC.9/3/2004 9:09 AM
DetailsProgram CodeInsert  CH9/3/2004 9:09 AM
DetailsEntity SubnameInsert  WALNUT GROVE MEDICAL CLINIC9/3/2004 9:09 AM
DatesParticipating Approval DateInsert  9/3/2004 9:09:36 AM9/3/2004 9:09 AM
DetailsStateInsert  Active9/3/2004 9:09 AM
DatesRegistration DateInsert  7/1/2002 12:00:00 AM9/3/2004 9:09 AM
DatesSigned By DateInsert   9/3/2004 9:09 AM
DatesStart DateInsert  7/1/2002 12:00:00 AM9/3/2004 9:09 AM
TerminationsTermination CommentsInsert   9/3/2004 9:09 AM
TerminationsTermination DateInsert   9/3/2004 9:09 AM
TerminationsTermination Effective DateInsert   9/3/2004 9:09 AM
TerminationsTermination ReasonInsert   9/3/2004 9:09 AM
DetailsComments PublicInsert  CORRECTED ENTITY NAME, NEW FAX NUMBER, NEW CONTACT9/3/2004 9:09 AM