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DOBBINS FAMILY PHARMACY, LLC
CAH251329-00 GREENE COUNTY HOSPITAL
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Covered Entity Details
Entity Name
GREENE COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH251329-00
Entity Address
1017 JACKSON AVENUE
LEAKESVILLE, MS 39451-9105
Medicare Provider Number
251329
Participating Start Date
4/1/2011
Last Recertification Date
8/25/2023
Entity Termination Date
10/1/2024
Pharmacy Details
Pharmacy Name
DOBBINS FAMILY PHARMACY, LLC
Pharmacy Address
1017 HIGHWAY 57
LEAKESVILLE, MS 39451-5807
Pharmacy Comments
Contract Details
Approval Date
7/6/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
GREG HAVARD, CHIEF EXECUTIVE OFFICER
(601) 947-9148
Contract Pharmacy Representative
Dobbins Family Pharmacy
Kayla Dobbins, owner
(601) 394-4720
Signed By Date
7/6/2020
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