340B Drug Pricing Program Database

Pharmacy Name

FRED'S PHARMACY #2099

Pharmacy Address

15 EAST STONEWALL RD
BYHALIA, MS 38611

Pharmacy Comments

11/30/2011 updated address (was 2438 Church Street P.O. Box 407)

Approval Date

3/13/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/30/2018
Pharmacy closed

Covered Entity Signing Official

Clifton Rodgers, Physician
(662) 349-6220

Contract Pharmacy Representative

Eddie McCullough, Pharmacist
(662) 838-2521

Signed By Date

1/21/2013