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NORTH SUNFLOWER MEDICAL CENTER
CAH251318-00 NORTH SUNFLOWER MEDICAL CENTER
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Covered Entity Details
Entity Name
NORTH SUNFLOWER MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH251318-00
Entity Address
840 NORTH OAK AVENUE
RULEVILLE, MS 38771
Medicare Provider Number
251318
Participating Start Date
9/16/2010
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
NORTH SUNFLOWER MEDICAL CENTER
Pharmacy Address
DBA NORTH SUNFLOWER MEDICAL CENTER PHARM
860 N OAK AVE
RULEVILLE, MS 38771
Pharmacy Comments
Contract Details
Approval Date
7/15/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/13/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
BILLY MARLOW, CEO
(662) 721-7370
Contract Pharmacy Representative
North Sunflower Medical Center
Mike Gilbow, Pharmacy Director
(662) 756-4381
Signed By Date
7/15/2015
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