Contract Pharmacy Details

WALGREEN CO.
CH040750 CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC.

Covered Entity Details

Entity Name

CENTRAL MISSISSIPPI CIVIC IMPROVEMENT ASSOCIATION, INC.

Subdivision Name

CENTRAL MS CIVIC IMPROVEMENT ASSOC., INC.D/B/A JACKSON-HINDS COMPREHENSIVE HEATLH CENTER MAIN SITE

Type

HRSA-Funded Health Center

340B ID

CH040750

Entity Address

3502 W Northside Dr
Jackson, MS 39213-4454

Grant Number

H80CS00084

Participating Start Date

12/1/1992

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05655
6970 OLD CANTON ROAD
RIDGELAND, MS 39157

Pharmacy Comments

01/24/2012 update address line 1 (was 6910)

Contract Details

Approval Date

1/6/2017

Contract Begin Date

4/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jasmin Chapman, CEO
(601) 364-5142

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/6/2017

340B Drug Pricing Program Database