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MISSISSIPPI CVS PHARMACY, L.L.C.
CH040570 FAMILY HEALTH CENTER INC
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTER INC
Subdivision Name
FAMILY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH040570
Entity Address
117 S 11th Ave
Laurel, MS 39440-4312
Grant Number
H80CS00538
Participating Start Date
10/1/1995
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
MISSISSIPPI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05777
501 NORTH 16TH AVE.
LAUREL, MS 39440
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rashad Ali, CEO
(601) 425-3033 Ext: 156
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2020
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