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COX BLYTHE HEALTHCARE GROUP CORP.
CH04910M NORTH MS PRIMARY HEALTH CARE INC
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Covered Entity Details
Entity Name
NORTH MS PRIMARY HEALTH CARE INC
Subdivision Name
NMPHC Wellness Center
Type
HRSA-Funded Health Center
340B ID
CH04910M
Entity Address
16025 Boundary Dr
Ashland, MS 38603-7738
Grant Number
H80CS00635
Participating Start Date
10/1/2023
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
COX BLYTHE HEALTHCARE GROUP CORP.
Pharmacy Address
DBA / COX-BLYTHE DRUG COMPANY
122 W COLLEGE ST
BOONEVILLE, MS 38829
Pharmacy Comments
Contract Details
Approval Date
1/10/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bill Stone, CEO
(662) 502-3149
Contract Pharmacy Representative
Cox Blythe Drug Co.
Audra Armistead, R.Ph.
(662) 728-5732
Signed By Date
1/10/2024
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