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SUMRALL DRUG STORE
CH04577A SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
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Covered Entity Details
Entity Name
SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.
Subdivision Name
SUMRALL FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH04577A
Entity Address
1016 HIGHWAY 42
SUMRALL, MS 39482
Grant Number
H80CS00610
Participating Start Date
10/1/2003
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
SUMRALL DRUG STORE
Pharmacy Address
1109 MS HWY 42
SUMRALL, MS 39482
Pharmacy Comments
Contract Details
Approval Date
12/6/2010
Contract Begin Date
12/6/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
HOPE THOMLEY, CEO
(601) 545-8700
Contract Pharmacy Representative
BEAU HADEN, OWNER
(601) 758-4243
Signed By Date
11/19/2010
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