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WALGREEN CO.
CH04207B GREATER MERIDIAN HEALTH CLINIC, INC
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Covered Entity Details
Entity Name
GREATER MERIDIAN HEALTH CLINIC, INC
Subdivision Name
Scooba Family Medical Center
Type
HRSA-Funded Health Center
340B ID
CH04207B
Entity Address
927 Kemper Street
Scooba, MS 39358-0176
Grant Number
H80CS00439
Participating Start Date
1/1/2011
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 02676
1728 HIGHWAY 45 NORTH
COLUMBUS, MS 39705
Pharmacy Comments
Contract Details
Approval Date
10/13/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
WILBERT L. JONES, CEO
(601) 693-0151 Ext: 116
Contract Pharmacy Representative
Greater Meridian Health Clinic, Inc.
DEBRA MCALLISTER, Director of Operations
(601) 693-0166
Signed By Date
10/13/2021
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