340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MISSISSIPPI CVS PHARMACY, L.L.C.
CAH251333-00 PEARL RIVER COUNTY HOSPITAL
Print
Covered Entity Details
Entity Name
PEARL RIVER COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH251333-00
Entity Address
305 W. MOODY STREET
POPLARVILLE, MS 39470
Medicare Provider Number
251333
Participating Start Date
4/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
MISSISSIPPI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05740
1701 A HWY 43 N
PICAYUNE, MS 39466
Pharmacy Comments
Contract Details
Approval Date
10/17/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bryan Keith Maxie, Regional Administrator
(601) 297-0503
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/17/2022
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