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FREDS PHARMACY #2431
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
FREDS PHARMACY #2431
Pharmacy Address
304 NORTHSIDE DR
NEWTON, MS 39345-2378
Pharmacy Comments
Contract Details
Approval Date
10/18/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/24/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
JILL BISHOP, CEO
(601) 625-7140
Contract Pharmacy Representative
Fred's Pharmacy
Betty Ngo, Sr. Director 340B Program Operations
(901) 481-0346
Signed By Date
10/18/2016
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