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NEAL'S EXPRESS PHARMACY LLC
DSH250104 ANDERSON REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
ANDERSON REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH250104
Entity Address
2124 14th Street
MERIDIAN, MS 39301
Medicare Provider Number
250104
Participating Start Date
4/1/2009
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
NEAL'S EXPRESS PHARMACY LLC
Pharmacy Address
DAVID NEAL'S EXPRESS PHARMACY LLC
3500 8TH ST
MERIDIAN, MS 39301
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/12/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John G. Anderson, CEO
(601) 553-6104
Contract Pharmacy Representative
Neal's Express Pharmacy
David Neal, Owner
(601) 453-2345
Signed By Date
1/13/2023
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