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CH04075Y CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC. (Active)
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Main Details
Name
CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC.
Subdivision Name
Gary Road Elementary School
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019309
340B ID
CH04075Y
Grant Number
H80CS00084
Additional Details
Current Program Status
Active
Registration Date
10/4/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/5/2017
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
Central Mississippi Civic Improvement Association, Inc.
Jasmin Chapman, Chief Executive Officer
(601) 364-5142
Primary Contact
Central Mississippi Civic Improvement Association, Inc.
Techandra J Mayes, Chief Financial Officer
(601) 364-5182
Addresses
Street Address
7241 Gary Road
Byram, MS 39272
Billing Address
Central Mississippi Civic Improvement Association, Inc.
PO Box 3437
Jackson, MS 39207
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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