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BURNHAM MCKINNEY PHARMACY #2
CH042430 THE COASTAL FAMILY HEALTH CENTER INC
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Covered Entity Details
Entity Name
THE COASTAL FAMILY HEALTH CENTER INC
Subdivision Name
COASTAL FAMILY HEALTH CENTER CORPORATE OFFICE
Type
HRSA-Funded Health Center
340B ID
CH042430
Entity Address
10467 Corporate Drive
Gulfport, MS 39503
Grant Number
H80CS00188
Participating Start Date
7/1/1999
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
BURNHAM MCKINNEY PHARMACY #2
Pharmacy Address
PO BOX 722
7709 HIGHWAY 613
ESCATAWPA, MS 39552-0722
Pharmacy Comments
Contract Details
Approval Date
10/15/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Angel Greer, Executive Director
(228) 374-2424
Contract Pharmacy Representative
Burnham Drugs
John McKinney, Owner
(228) 396-2228
Signed By Date
10/15/2013
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