340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MISSISSIPPI CVS PHARMACY, L.L.C.
DSH250117 HIGHLAND COMMUNITY HOSPITAL
Print
Covered Entity Details
Entity Name
HIGHLAND COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH250117
Entity Address
130 Highland Parkway
PICAYUNE, MS 39466
Medicare Provider Number
250117
Participating Start Date
10/1/2007
Last Recertification Date
8/15/2024
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