340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OKOLONA PHARMACY LLC
CAH251302-00 BOA VIDA HOSPITAL OF ABERDEEN, MS, LLC, D/B/A MONROE REGIONAL HOSPITAL
Print
Covered Entity Details
Entity Name
BOA VIDA HOSPITAL OF ABERDEEN, MS, LLC, D/B/A MONROE REGIONAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH251302-00
Entity Address
400 SOUTH CHESTNUT ST
ABERDEEN, MS 39730
Medicare Provider Number
251302
Participating Start Date
9/24/2010
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
OKOLONA PHARMACY LLC
Pharmacy Address
210 W MAIN ST
OKOLONA, MS 38860-1425
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Chris Chandler, CEO
(662) 369-2455
Contract Pharmacy Representative
Okolona Pharmacy
Tony Smith, Owner
(662) 447-0300
Signed By Date
1/17/2023
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