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WALGREEN CO
CH04306A NORTHEAST MISSISSIPPI HEALTH CARE, INC.
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Covered Entity Details
Entity Name
NORTHEAST MISSISSIPPI HEALTH CARE, INC.
Subdivision Name
MT. PLEASANT FAMILY HLTH CLINIC
Type
HRSA-Funded Health Center
340B ID
CH04306A
Entity Address
154 OLD MT. PLEASANT ROAD
MOUNT PLEASANT, MS 38635
Grant Number
H80CS00432
Participating Start Date
10/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #10517
7030 HACKS CROSS RD
OLIVE BRANCH, MS 38654-4471
Pharmacy Comments
Contract Details
Approval Date
2/15/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Clifton Rodgers, Physician
(662) 349-6220
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
2/15/2023
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