340B Drug Pricing Program Database
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DSH250001AK University of Mississippi Medical Center (Active)
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Main Details
Name
University of Mississippi Medical Center
Subdivision Name
STATE OF MISSISSIPPI - UNIVERSITY - CH Peds Urgent Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH250001AK
Medicare Provider Number
250001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/12/2023
Last Recertification Date
8/29/2024
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
1010 LAKELAND PL
FLOWOOD, MS 39232-6678
Billing Address
University of Mississippi Medical Center
2500 North State Street
Jackson, MS 39216
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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