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WALGREEN CO.
CH042070 GREATER MERIDIAN HEALTH CLINIC, INC
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Covered Entity Details
Entity Name
GREATER MERIDIAN HEALTH CLINIC, INC
Subdivision Name
GREATER MERIDIAN HEALTH CLINIC, INC.
Type
HRSA-Funded Health Center
340B ID
CH042070
Entity Address
2701 Davis St
Meridian, MS 39301-5708
Grant Number
H80CS00439
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 10067
1005 W BEACON ST
PHILADELPHIA, MS 39350-3203
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
WILBERT L. JONES, CEO
(601) 693-0151 Ext: 116
Contract Pharmacy Representative
Walgreen Co
Christine Fullmer, Client Relationship Analyst
(847) 315-5300
Signed By Date
4/14/2020
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