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SERVICE REXALL DRUGS
CAH251317-00 SIMPSON GENERAL HOSPITAL
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Covered Entity Details
Entity Name
SIMPSON GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH251317-00
Entity Address
1842 SIMPSON HWY 149
MENDENHALL, MS 39114
Medicare Provider Number
251317
Participating Start Date
10/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
SERVICE REXALL DRUGS
Pharmacy Address
3069 SIMPSON HIGHWAY 13
MENDENHALL, MS 39114-3077
Pharmacy Comments
10/31/2013 Admin note - Pharmacy moved from 167 MAIN STREET N MENDENHALL, MS 39114 in April 2012
Contract Details
Approval Date
10/20/2011
Contract Begin Date
10/11/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Randall O. Neely, CEO
(601) 847-7214
Contract Pharmacy Representative
John Edwin White, Owner
(601) 847-2323
Signed By Date
9/19/2011
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