340B Drug Pricing Program Database
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DSH250001AG University of Mississippi Medical Center (Active)
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Main Details
Name
University of Mississippi Medical Center
Subdivision Name
Pavilion Transplant Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH250001AG
Medicare Provider Number
250001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/31/2019
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
University of MIssissippi Medical Center
Jeffrey Grimsley, CFO-Health System
(601) 815-6270
Primary Contact
University of Mississippi Medical Center
Kelsey H Raymer, Health System 340B Operations Director
(601) 984-2676
Addresses
Street Address
2500 North State Street
Suite H
Jackson, MS 39216
Billing Address
University of Mississippi Medical Center
Attn: Pharmacy
2500 North State Street
Jackson, MS 39216
Comments
Medicaid Billing
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