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MOORE'S PHARMACY
CH04272B EAST CENTRAL MISSISSIPPI HEALTH CARE INC
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Covered Entity Details
Entity Name
EAST CENTRAL MISSISSIPPI HEALTH CARE INC
Subdivision Name
SEBASTOPOL CLINIC
Type
HRSA-Funded Health Center
340B ID
CH04272B
Entity Address
1488 Highway 487
Sebastopol, MS 39359-0150
Grant Number
H80CS00431
Participating Start Date
7/1/2002
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
MOORE'S PHARMACY
Pharmacy Address
103 CHADWICK AVE E
WALNUT GROVE, MS 39189
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
Moore's Pharmacy
Patrick Berryman, POC
(804) 427-8900
Signed By Date
3/29/2023
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