340B Drug Pricing Program Database

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Effective Sunday, September 1, OPA is implementing a change to the export format for Medicaid and NPI numbers. This change affects covered entity exports that include Medicaid and/or NPI billing numbers, and the CE Daily Report in Excel format. If the number is associated with more than one state, all the states will be listed between one set of parentheses following the number - for example, 1275575227 (IN,MI,OH). This change is necessary to ensure that the exported data does not exceed Excel’s limit for field length.

PREMIER PHARMACY SERVICES
CAH251300-00 INDEPENDENT HEALTHCARE MANAGMENT, INC. D/B/A SE LACKEY MEMORIAL HOSPITAL

Covered Entity Details

Critical Access Hospital
CAH251300-00
330 N. BROAD ST.
FOREST, MS 39074
251300
1/1/2011
8/29/2024


Pharmacy Details

410 CLOVERLEAF DR
BALDWIN PARK, CA 91706

Contract Details

10/15/2018
1/1/2019

7/13/2021
Business decision by covered entity and/or pharmacy


Contacts


Sydney Sawyer, CEO
(601) 469-4151 Ext: 301



Good Health, Inc
Todd Weber, Director, Government Programs & Strategic Initiatives
(203) 212-4717
10/15/2018