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WAL-MART PHARMACY 10-0305
CH042720 EAST CENTRAL MISSISSIPPI HEALTH CARE, INC.
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Covered Entity Details
Entity Name
EAST CENTRAL MISSISSIPPI HEALTH CARE, INC.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH042720
Entity Address
1490 HIGHWAY 487
SEBASTOPOL, MS 39359
Grant Number
H80CS00431
Participating Start Date
7/1/2002
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0305
Pharmacy Address
905 HIGHWAY 16 WEST
CARTHAGE, MS 39051
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JILL BISHOP, CEO
(601) 625-7140
Contract Pharmacy Representative
WALMART
Julie Howard, Manager Contracting & Channel Management
(479) 277-1498
Signed By Date
7/15/2019
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