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ASHLAND DISCOUNT DRUG
CH049100 NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
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Covered Entity Details
Entity Name
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Subdivision Name
Benton Medical Center
Type
HRSA-Funded Health Center
340B ID
CH049100
Entity Address
15921 Boundary Dr
Ashland, MS 38603-7740
Grant Number
H80CS00635
Participating Start Date
9/9/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
ASHLAND DISCOUNT DRUG
Pharmacy Address
15917 BOUNDARY DRIVE
PO BOX 126
ASHLAND, MS 38603
Pharmacy Comments
Contract Details
Approval Date
1/1/2006
Contract Begin Date
1/1/2006
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
12/27/2005
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