Contract Pharmacy Details

CENTERWELL PHARMACY, INC.
CH045770 Southeast Mississippi Rural Health Initiative, Inc.

Covered Entity Details

Entity Name

Southeast Mississippi Rural Health Initiative, Inc.

Subdivision Name

SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE, INC.

Type

HRSA-Funded Health Center

340B ID

CH045770

Entity Address

5488 U S Highway 49
Hattiesburg, MS 39401-7806

Grant Number

H80CS00610

Participating Start Date

10/1/2002

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

CENTERWELL PHARMACY, INC.

Pharmacy Address

11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDO, FL 32824

Pharmacy Comments

Contract Details

Approval Date

1/15/2025

Contract Begin Date

4/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Janice Robinson, CEO
(601) 545-3700

Contract Pharmacy Representative

CenterWell Pharmacy
Jay Duprey, ASSOCIATE DIRECTOR, CHANNEL DEVELOPMENT
(248) 921-7578

Signed By Date

1/15/2025

340B Drug Pricing Program Database