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MEDICAL CENTER PHARMACY
CH045780 AMITE COUNTY MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
AMITE COUNTY MEDICAL SERVICES, INC.
Subdivision Name
AMITE COUNTY MEDICAL SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH045780
Entity Address
102 WEST FREEDOM DRIVE
LIBERTY, MS 39645-0511
Grant Number
H80CS00609
Participating Start Date
7/1/2002
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
MEDICAL CENTER PHARMACY
Pharmacy Address
312 MARION AVE.
MCCOMB, MS 39648-2708
Pharmacy Comments
Contract Details
Approval Date
1/20/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Baili Harvey, Finance Director
(601) 657-4326
Contract Pharmacy Representative
Guy's Pharmacy of Brookhaven
Keith Guy, Pharmacist
(601) 684-4127
Signed By Date
1/20/2023
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