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SALTILLO PHARMACY AND SOLUTIONS
CH043920 MANTACHIE RURAL HEALTH CARE INC
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Covered Entity Details
Entity Name
MANTACHIE RURAL HEALTH CARE INC
Subdivision Name
Mantachie Rural Health Care, Inc.
Type
HRSA-Funded Health Center
340B ID
CH043920
Entity Address
5681 Highway 363
Mantachie, MS 38855-7632
Grant Number
H80CS00096
Participating Start Date
10/1/1996
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
SALTILLO PHARMACY AND SOLUTIONS
Pharmacy Address
2698 HIGHWAY 145
SALTILLO, MS 38866-6941
Pharmacy Comments
Contract Details
Approval Date
12/15/2020
Contract Begin Date
12/15/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/5/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MARJORIE MCKINNEY, CEO
(662) 282-4226 Ext: 114
Contract Pharmacy Representative
Iuka Discount Drugs
Lee Griffin, Owner
(662) 279-0599
Signed By Date
12/15/2020
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