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MEDICAL PLAZA ON HARPER
RRC250009-00 MAGNOLIA REGIONAL HEALTH CENTER
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Covered Entity Details
Entity Name
MAGNOLIA REGIONAL HEALTH CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC250009-00
Entity Address
611 ALCORN DRIVE
CORINTH, MS 38834
Medicare Provider Number
250009
Participating Start Date
4/1/2017
Last Recertification Date
8/15/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
MEDICAL PLAZA ON HARPER
Pharmacy Address
1425 S HARPER RD
CORINTH, MS 38834-6613
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
James McLaughlin Hobson, Chief Executive Officer
(662) 293-7661
Contract Pharmacy Representative
Medical Plaza on Harper
Bart Doran, Owner
(662) 396-6369
Signed By Date
7/17/2023
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