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MEDICAL PLAZA ON HARPER
CH04910A NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
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Covered Entity Details
Entity Name
NORTH MISSISSIPPI PRIMARY HEALTH CARE, INC.
Subdivision Name
WALNUT MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH04910A
Entity Address
531 Main Street
WALNUT, MS 38683
Grant Number
H80CS00635
Participating Start Date
4/1/2006
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
MEDICAL PLAZA ON HARPER
Pharmacy Address
1425 S HARPER RD
CORINTH, MS 38834-6613
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bill Stone, CEO
(662) 502-3149
Contract Pharmacy Representative
Medical Plaza
Rick W. Quinn, Owner
(662) 286-6991 Ext: 4
Signed By Date
10/16/2023
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