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K & B MISSISSIPPI CORPORATION
CH045770 Southeast Mississippi Rural Health Initiative, Inc.
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Covered Entity Details
Entity Name
Southeast Mississippi Rural Health Initiative, Inc.
Subdivision Name
SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
Type
HRSA-Funded Health Center
340B ID
CH045770
Entity Address
5488 U S Highway 49
Hattiesburg, MS 39401-7806
Grant Number
H80CS00610
Participating Start Date
10/1/2002
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
K & B MISSISSIPPI CORPORATION
Pharmacy Address
RITE AID #7221
100 HIGHWAY 42
PETAL, MS 39465
Pharmacy Comments
Contract Details
Approval Date
9/6/2012
Contract Begin Date
9/6/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/16/2018
Ownership change
Contacts
Covered Entity Signing Official
POLLY EUBANKS, CFO
(601) 545-8700
Contract Pharmacy Representative
Rite Aid
Ruth Lightner, Director
(717) 731-6524
Signed By Date
8/21/2012
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