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TAYLORSVILLE DRUGS
CAH251325-00 COVINGTON COUNTY HOSPITAL
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Covered Entity Details
Entity Name
COVINGTON COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH251325-00
Entity Address
701 SOUTH HOLLY STREET
COLLINS, MS 39428
Medicare Provider Number
251325
Participating Start Date
8/18/2010
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
TAYLORSVILLE DRUGS
Pharmacy Address
TAYLORSVILLE DRUGS
300 PINE ST
PO BOX 1397
TAYLORSVILLE, MS 39168
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
Gregg Gibbes, CEO
(601) 765-6711
Contract Pharmacy Representative
Taylorsville Drugs
Timothy Willamson, Owner
(601) 452-5100
Signed By Date
1/15/2021
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