Contract Pharmacy Details

WALGREEN CO.
CH04272A EAST CENTRAL MISSISSIPPI HEALTH CARE, INC.

Covered Entity Details

Entity Name

EAST CENTRAL MISSISSIPPI HEALTH CARE, INC.

Subdivision Name

WALNUT GROVE MEDICAL CLINIC

Type

HRSA-Funded Health Center

340B ID

CH04272A

Entity Address

199 RIMMER STREET
WALNUT GROVE, MS 39189

Grant Number

H80CS00431

Participating Start Date

7/1/2002

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 10067
1005 W BEACON ST
PHILADELPHIA, MS 39350-3203

Pharmacy Comments

Contract Details

Approval Date

3/29/2023

Contract Begin Date

3/29/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

JILL BISHOP, CEO
(601) 625-7140

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

3/29/2023

340B Drug Pricing Program Database