340B Drug Pricing Program Database
WALGREEN CO.
DSH250001 University of Mississippi Medical Center - information as of 4/29/2025 1:57:02 AM
Covered Entity Details
Entity Name
University of Mississippi Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH250001
Entity Address
2500 NORTH STATE ST.
JACKSON, MS 39216
Medicare Provider Number
250001
Participating Start Date
4/1/1998
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07184
2896 MCDOWELL ROAD EXTENSION
JACKSON, MS 39204-4238
Pharmacy Comments
Contract Details
Approval Date
7/24/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/5/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
William Thompson, CFO
(601) 984-4113
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/24/2014
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