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CYSTIC FIBROSIS SERVICES, LLC
SCH250043-00 Neshoba County General Hospital
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Covered Entity Details
Entity Name
Neshoba County General Hospital
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH250043-00
Entity Address
HWY 19 South
1001 Holland Avenue
Philadelphia, MS 39350
Medicare Provider Number
250043
Participating Start Date
1/1/2014
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
CYSTIC FIBROSIS SERVICES, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16280
10530 JOHN W ELLIOTT DR STE 200
FRISCO, TX 75033
Pharmacy Comments
Contract Details
Approval Date
4/9/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott McNair, CFO
(601) 663-1233
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/9/2019
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