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FRED'S PHARMACY
SCH250043-00 Neshoba County General Hospital
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Covered Entity Details
Entity Name
Neshoba County General Hospital
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH250043-00
Entity Address
HWY 19 South
1001 Holland Avenue
Philadelphia, MS 39350
Medicare Provider Number
250043
Participating Start Date
1/1/2014
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
FRED'S PHARMACY
Pharmacy Address
714 PECAN AVENUNE
PHILADELPHIA, MS 39350
Pharmacy Comments
Contract Details
Approval Date
10/16/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/15/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Scott McNair, CFO
(601) 663-1233
Contract Pharmacy Representative
Shannon Strickland, SVP, Pharmacy Development
(901) 238-3113
Signed By Date
10/16/2014
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