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THE PHARMACY AT SINGING RIVER GULFPORT
RRC250040-00 SINGING RIVER HEALTH SYSTEM
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Covered Entity Details
Entity Name
SINGING RIVER HEALTH SYSTEM
Subdivision Name
SINGING RIVER HOSPITAL
Type
Rural Referral Center
340B ID
RRC250040-00
Entity Address
2809 DENNY AVENUE
PASCAGOULA, MS 39581
Medicare Provider Number
250040
Participating Start Date
7/1/2024
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
THE PHARMACY AT SINGING RIVER GULFPORT
Pharmacy Address
15200 COMMUNITY RD
GULFPORT, MS 39503
Pharmacy Comments
Contract Details
Approval Date
5/30/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/30/2024
Agreement registered in error
Contacts
Covered Entity Signing Official
Heath Allen Thompson, Administrator Ancillary Services
(228) 818-1191
Contract Pharmacy Representative
Singing River Gulfport Retail
Chris Collins, Pharmacy Manager
(228) 575-7365
Signed By Date
4/5/2024
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