Contract Pharmacy Details

QUINN'S FAMILY PHARMACY
CAH251322-00 LAIRD HOSPITAL, INC.

Covered Entity Details

Entity Name

LAIRD HOSPITAL, INC.

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH251322-00

Entity Address

25117 HWY 15 BYPASS
UNION, MS 39365

Medicare Provider Number

251322

Participating Start Date

1/1/2011

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

QUINN'S FAMILY PHARMACY

Pharmacy Address

24944 HIGHWAY 15
UNION, MS 39365-8587

Pharmacy Comments

Contract Details

Approval Date

7/12/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Suzanne Mize, 340B Administrator
(205) 459-9180

Contract Pharmacy Representative

Quinn's Family Pharmacy
Tesa Quinn, Owner
(769) 222-1054

Signed By Date

7/12/2019

340B Drug Pricing Program Database