340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-1025
DSH250097 SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH250097
Entity Address
215 MARION AVE.
MCCOMB, MS 39648-2705
Medicare Provider Number
250097
Participating Start Date
9/9/2005
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1025
Pharmacy Address
1608 VETERANS BLVD
MCCOMB, MS 39648
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Williams, Chief Operating Officer
(601) 249-1882
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
1/15/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session