340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH250097 SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
SOUTHWEST MISSISSIPPI REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH250097
Entity Address
215 MARION AVE.
MCCOMB, MS 39648-2705
Medicare Provider Number
250097
Participating Start Date
9/9/2005
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01166
719 BROOKWAY BLVD
BROOKHAVEN, MS 39601-2639
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Williams, Chief Operating Officer
(601) 249-1882
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session