340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH250048 ST. DOMINIC-JACKSON MEMORIAL HOSPITAL (Active)
Print
Main Details
Name
ST. DOMINIC-JACKSON MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH250048
Medicare Provider Number
250048
Additional Details
Current Program Status
Active
Registration Date
6/6/2008
Participating Start Date
7/1/2008
Participating Approval Date
6/9/2008
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
St Dominic Hospital
Sam Scott, Sr Vice President / CFO
(601) 200-6570
Primary Contact
St. Dominic Hospital
Katie Schipper, Director of Pharmacy
(601) 200-6031
Addresses
Street Address
969 LAKELAND DRIVE
JACKSON, MS 39216-4606
Billing Address
FMOLHS ACCOUNTS PAYABLE
P.O. Box 83880
Baton Rouge, LA 70884-3880
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
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