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CH04578B AMITE COUNTY MEDICAL SERVICES, INC. (Active)
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Main Details
Name
AMITE COUNTY MEDICAL SERVICES, INC.
Subdivision Name
LIBERTY DENTAL SERVICES
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001440
340B ID
CH04578B
Grant Number
H80CS00609
Additional Details
Current Program Status
Active
Registration Date
4/4/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/12/2016
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
Amite County Medical Services, Inc.
Baili Harvey, Finance Director
(601) 657-4326
Primary Contact
Amite County Medical Services, Inc.
Sally Toler, Executive Director
(601) 657-4326
Addresses
Street Address
102 FREEDOM DRIVE
LIBERTY, MS 39645-0302
Billing Address
Amite County Medical Services, Inc., DBA Liberty Dental Services
P. O. Box 511
Liberty, MS 39645-0511
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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