No
Contract Detail | ALLCARE PHARMACY | 600 W MAIN ST |
| HEBER SPRINGS | AR | 72543-2920 | 04/17/2014 | 07/01/2014 | | 12/02/2020 | 01/29/2021 |
Contract Detail | ARKANSAS CVS PHARMACY, L.L.C. | CVS PHARMACY # 17011 |
501 ELSINGER BLVD
| CONWAY | AR | 72032 | 10/14/2021 | 01/01/2022 | | 04/01/2023 | 01/26/2024 |
Contract Detail | BAPTIST HEALTH MEDICAL TOWERS PHARMACY | 9601 BAPTIST HEALTH DR STE 109 |
| LITTLE ROCK | AR | 72205 | 01/16/2025 | 04/01/2025 | | | 04/01/2025 |
Contract Detail | BENNETT HEALTH SERVICES INC | DBA FAIRFIELD BAY PHARMACY |
367 DAVE CREEK PKWY
| FAIRFIELD BAY | AR | 72088 | 04/02/2015 | 07/01/2015 | | | 07/13/2016 |
Contract Detail | CORNERSTONE PHARMACY AT GREERS FERRY | 8470 EDGEMONT RD |
| GREERS FERRY | AR | 72067 | 10/14/2024 | 01/01/2025 | | | 01/01/2025 |
Contract Detail | CVS CAREMARK | DBA CVS/CAREMARK OR CF# 11506 |
1 GREAT VALLEY BOULEVARD
| WILKES BARRE | PA | 18706 | 10/14/2021 | 01/01/2022 | | | 01/01/2022 |
Contract Detail | CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC | DBA CVS/CAREMARK 48067 |
1780 WALL ST
| MT PROSPECT | IL | 60056 | 10/14/2021 | 01/01/2022 | | | 01/01/2022 |
Contract Detail | FRED'S PHARMACY | 308 S 7TH ST |
| HEBER SPRINGS | AR | 72543-3719 | 01/17/2014 | 04/01/2014 | | 09/11/2015 | 07/13/2016 |
Contract Detail | FRED'S PHARMACY | 308 S 7TH ST |
| HEBER SPRINGS | AR | 72543-3719 | 10/04/2016 | 01/01/2017 | | 10/08/2019 | 10/28/2019 |
Contract Detail | HARPS PHARMACY #163 | 901 W MAIN ST |
| HEBER SPRINGS | AR | 72543 | 01/16/2015 | 04/01/2015 | | 07/15/2021 | 07/15/2021 |
Contract Detail | IVY FAMILY PHARMACY, INC. | DBA FAMILY DISCO PHARMACY |
120 S 4TH ST
| HEBER SPRINGS | AR | 72543-7254 | 01/17/2023 | 04/01/2023 | | | 04/01/2023 |
Contract Detail | JOHNSON PHARMACY INC | 6124 HEBER SPRINGS RD W |
| QUITMAN | AR | 72131-0164 | 07/02/2014 | 10/01/2014 | | 01/01/2018 | 08/31/2018 |
Contract Detail | JOHNSON PHARMACY INC | 6124 HEBER SPRINGS RD W |
| QUITMAN | AR | 72131-0164 | 01/17/2023 | 04/01/2023 | | | 04/01/2023 |
Contract Detail | LOUISIANA CVS PHARMACY, L.L.C. | DBA: CVS/PHARMACY # 08921 |
2831 BELLE CHASE HWY.
| TERRYTOWN | LA | 70056 | 10/14/2021 | 01/01/2022 | | 04/01/2023 | 01/26/2024 |
Contract Detail | R2H2 BUSINESS ENTERPRISES | DBA REEDHUTCHINS PHARMACY |
408 W. MAIN ST.
| HEBER SPRINGS | AR | 72543 | 01/17/2023 | 04/01/2023 | | | 04/01/2023 |
Contract Detail | SCPG ARKANSAS LLC | DBA: EXPRESS RX OF HEBER SPRINGS |
600 W MAIN ST
| HEBER SPRINGS | AR | 72543-2920 | 04/13/2021 | 07/01/2021 | | | 07/01/2021 |
Contract Detail | WAL-MART CENTRAL FILL 10-2670 | 608 SPRING HILL DR # 3 SUITE 300 |
| SPRING | TX | 77386 | 07/13/2017 | 10/01/2017 | | | 10/01/2017 |
Contract Detail | WAL-MART PHARMACY 10-0281 | 1500 HIGHWAY 25B NORTH |
| HEBER SPRINGS | AR | 72543 | 11/29/2012 | 01/01/2013 | | | 07/13/2016 |
Contract Detail | WAL-MART PHARMACY 10-0788 | 1966 HWY 65 SOUTH |
| CLINTON | AR | 72031 | 01/17/2023 | 04/01/2023 | | | 04/01/2023 |
Contract Detail | WAL-MART PHARMACY 10-5997 | 9600 PARKSOUTH CT. SUITE 100 |
| ORLANDO | FL | 32837 | 07/13/2017 | 10/01/2017 | | | 10/01/2017 |
Contract Detail | WALGREEN CO. | DBA: WALGREENS # 09766 |
200 E RACE AVE
| SEARCY | AR | 72143 | 04/12/2023 | 07/01/2023 | | | 07/01/2023 |
CAH041312-01 | Child | CAH | BAPTIST HEALTH MEDICAL CENTER HEBER SPRINGS | Baptist Health Therapy Clinic - Heber Springs | 1415 Highway 25B | Heber Springs | AR | Active |
CAH041312-02 | Child | CAH | BAPTIST HEALTH MEDICAL CENTER HEBER SPRINGS | Baptist Health Therapy Center - Fairfield Bay | 381 Dave Creek Parkway | Fairfield Bay | AR | Terminated |
CAH041312-03 | Child | CAH | BAPTIST HEALTH MEDICAL CENTER HEBER SPRINGS | Baptist Health Family Clinic - Greers Ferry | 8544 Edgemont Road | Greers Ferry | AR | Active |
CAH041312-04 | Child | CAH | BAPTIST HEALTH MEDICAL CENTER HEBER SPRINGS | Baptist Health Family Clinic - Heber Springs | 1415 Hwy 25B | Heber Springs | AR | Active |
CAH041312-05 | Child | CAH | BAPTIST HEALTH MEDICAL CENTER HEBER SPRINGS | Fairfield Bay RHC | 110 Village Place, Suite 2B | Fairfield Bay | AR | Terminated |
CAH041312-06 | Child | CAH | BAPTIST HEALTH MEDICAL CENTER HEBER SPRINGS | BH Heber Springs - Campus Clinic | 1800 Bypass Road | Heber Springs | AR | Active |
Details | Last Recertification Date | Update | Recertification | 9/14/2023 2:38:25 PM | 9/3/2024 2:18:20 PM | 9/3/2024 2:18 PM |
Details | Last Recertification Date | Update | Recertification | 9/14/2022 9:54:57 AM | 9/14/2023 2:38:25 PM | 9/14/2023 2:38 PM |
Details | Last Recertification Date | Update | Recertification | 9/9/2021 9:33:18 AM | 9/14/2022 9:54:57 AM | 9/14/2022 9:54 AM |
Details | Last Recertification Date | Update | Recertification | 9/14/2020 4:15:41 PM | 9/9/2021 9:33:18 AM | 9/9/2021 9:33 AM |
Details | Last Recertification Date | Update | Recertification | 9/16/2019 12:02:30 PM | 9/14/2020 4:15:41 PM | 9/14/2020 4:15 PM |
Details | Last Recertification Date | Update | Recertification | 9/3/2018 7:46:57 AM | 9/16/2019 12:02:30 PM | 9/16/2019 12:02 PM |
Medicaid Billing | Medicaid: Number | Delete | Change Request | 130609105 (AR) | | 8/1/2019 2:05 PM |
Medicaid Billing | NPI: Number | Delete | Change Request | 1609804822 ( ) | | 8/1/2019 2:05 PM |
Contacts | Authorizing Official | Update | Profile Change Request | Beaulieu, Brent
VP of Finance
Baptist Health
5012022017 | Beaulieu, Brent
CFO
Baptist Health
5012022017 | 4/5/2019 3:34 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609804822 | 9/3/2018 7:46 AM |
Details | Last Recertification Date | Update | Recertification | 11/29/2017 6:44:44 PM | 9/3/2018 7:46:57 AM | 9/3/2018 7:46 AM |
Details | Last Recertification Date | Update | Recertification | 8/23/2016 12:00:00 AM | 11/29/2017 6:44:44 PM | 11/29/2017 6:44 PM |
Medicaid Billing | Medicaid: Is Primary | Insert | Change Request | | False | 9/27/2017 4:31 PM |
Medicaid Billing | Medicaid: Number | Insert | Change Request | | 130609105 | 9/27/2017 4:31 PM |
Medicaid Billing | Medicaid: State | Insert | Change Request | | AR | 9/27/2017 4:31 PM |
Contacts | Primary Contact | Insert | Change Request | | Jaeger, Stefanie
Sr. Reimbursement Specialist
Baptist Health
5012021813 | 9/26/2017 6:10 PM |
Contacts | Authorizing Official | Update | | Beaulieu, Brent
VP of Finance
5012022017 | Beaulieu, Brent
VP of Finance
Baptist Health
5012022017 | 9/26/2017 5:56 PM |
Contacts | Authorizing Official | Insert | | | Beaulieu, Brent
VP of Finance
5012022017 | 7/26/2017 12:26 PM |
Addresses | Main Address | Insert | | |
1800 BYPASS ROAD
HEBER SPRINGS, AR 72543 | 8/23/2016 5:38 PM |
Details | Last Recertification Date | Update | | 8/11/2015 12:00:00 AM | 8/23/2016 12:00:00 AM | 8/23/2016 5:38 PM |
Details | Last Recertification Date | Update | | 9/5/2014 12:00:00 AM | 8/11/2015 12:00:00 AM | 8/11/2015 5:38 PM |
Details | Last Recertification Date | Update | | 8/21/2013 12:00:00 AM | 9/5/2014 12:00:00 AM | 9/5/2014 11:55 AM |
Details | Last Recertification Date | Update | | 7/1/2012 12:00:00 AM | 8/21/2013 12:00:00 AM | 8/21/2013 11:00 AM |
Details | Last Recertification Date | Update | | | 7/1/2012 12:00:00 AM | 5/9/2012 8:48 AM |
Details | Last Recertification Date | Insert | | | | 9/27/2010 12:41 PM |
Details | Grant Number | Insert | | | | 9/27/2010 12:41 PM |
Details | 340B ID | Insert | | | CAH041312-00 | 9/27/2010 12:41 PM |
Details | Is Authorizing Official EHB Data | Insert | | | | 9/27/2010 12:41 PM |
Dates | Last Date That 340B Drugs Purchased | Insert | | | | 9/27/2010 12:41 PM |
Details | Medicare Provider Number | Insert | | | 041312 | 9/27/2010 12:41 PM |
Details | Entity Name | Insert | | | BAPTIST HEALTH MEDICAL CENTER HEBER SPRINGS | 9/27/2010 12:41 PM |
Details | Program Code | Insert | | | CAH | 9/27/2010 12:41 PM |
Details | Entity Subname | Insert | | | | 9/27/2010 12:41 PM |
Dates | Participating Approval Date | Insert | | | 9/22/2010 12:00:00 AM | 9/27/2010 12:41 PM |
Details | State | Insert | | | Active | 9/27/2010 12:41 PM |
Dates | Registration Date | Insert | | | 9/22/2010 12:00:00 AM | 9/27/2010 12:41 PM |
Dates | Signed By Date | Insert | | | 9/22/2010 12:00:00 AM | 9/27/2010 12:41 PM |
Dates | Start Date | Insert | | | 9/27/2010 12:00:00 AM | 9/27/2010 12:41 PM |
Terminations | Termination Comments | Insert | | | | 9/27/2010 12:41 PM |
Terminations | Termination Date | Insert | | | | 9/27/2010 12:41 PM |
Terminations | Termination Effective Date | Insert | | | | 9/27/2010 12:41 PM |
Terminations | Termination Reason | Insert | | | | 9/27/2010 12:41 PM |