340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-3593
CH04306D NORTHEAST MISSISSIPPI HEALTH CARE, INC.
Print
Covered Entity Details
Entity Name
NORTHEAST MISSISSIPPI HEALTH CARE, INC.
Subdivision Name
DeSoto Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH04306D
Entity Address
7535 Airways Boulevard
Southaven, MS 38671-5816
Grant Number
H80CS00432
Participating Start Date
10/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3593
Pharmacy Address
2401 GOODMAN ROAD
HORN LAKE, MS 38637
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
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
2/15/2023
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