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Walmart Pharmacy 10-7611
SCH250043-00 Neshoba County General Hospital
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Covered Entity Details
Entity Name
Neshoba County General Hospital
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH250043-00
Entity Address
HWY 19 South
1001 Holland Avenue
Philadelphia, MS 39350
Medicare Provider Number
250043
Participating Start Date
1/1/2014
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
Walmart Pharmacy 10-7611
Pharmacy Address
2501 Perry Rd
Plainfield, IN 46168
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott McNair, CFO
(601) 663-1233
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/11/2023
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