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DOBBINS FAMILY PHARMACY, LLC
SCH250036-00 GEORGE COUNTY HOSPITAL
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Covered Entity Details
Entity Name
GEORGE COUNTY HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH250036-00
Entity Address
859 WINTER STREET
LUCEDALE, MS 39452-6603
Medicare Provider Number
250036
Participating Start Date
4/1/2011
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
DOBBINS FAMILY PHARMACY, LLC
Pharmacy Address
1017 HIGHWAY 57
LEAKESVILLE, MS 39451-5807
Pharmacy Comments
Contract Details
Approval Date
7/3/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christy E Roberts, Compliance
(601) 766-6394
Contract Pharmacy Representative
Dobbins Family Pharmacy
Kayla Dobbins, owner
(601) 394-4720
Signed By Date
7/3/2020
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