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MISSISSIPPI CVS PHARMACY, L.L.C.
CAH251331-00 Baptist Memorial Hospital-Calhoun
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Covered Entity Details
Entity Name
Baptist Memorial Hospital-Calhoun
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH251331-00
Entity Address
140 BURKE-CALHOUN CITY ROAD
CALHOUN CITY, MS 38916
Medicare Provider Number
251331
Participating Start Date
7/1/2018
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
MISSISSIPPI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04376
1209 SUNSET DR.
GRENADA, MS 38901
Pharmacy Comments
Contract Details
Approval Date
7/26/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kimberly Young, Vice President-Finance Operations
(901) 227-4080
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/26/2023
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