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MISSISSIPPI CVS PHARMACY, L.L.C.
STD39302 West Alabama AIDS Outreach dba Five Horizons Health Services
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Covered Entity Details
Entity Name
West Alabama AIDS Outreach dba Five Horizons Health Services
Subdivision Name
Five Horizons Health Services
Type
Sexually Transmitted Diseases
340B ID
STD39302
Entity Address
1926 23rd Avenue
Meridian, MS 39302
Grant Number
NH25PS005147
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
MISSISSIPPI CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 6031
1912 JACKSON AVE. W
OXFORD, MS 38655
Pharmacy Comments
Contract Details
Approval Date
5/13/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Will Rainer, Chief Compliance Officer
(659) 734-2319
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2025
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