340B Drug Pricing Program Database
ELLISON MANAGEMENT PLLC
DSH040015 MENA REGIONAL HEALTH SYSTEM - information as of 4/23/2025 11:56:14 PM
Covered Entity Details
Entity Name
MENA REGIONAL HEALTH SYSTEM
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040015
Entity Address
311 NORTH MORROW
MENA, AR 71953
Medicare Provider Number
040015
Participating Start Date
7/1/2010
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
ELLISON MANAGEMENT PLLC
Pharmacy Address
DBA ELLISON FAMILY PHARMACY
601 HIGHWAY 71 N
MENA, AR 71953
Pharmacy Comments
Contract Details
Approval Date
10/9/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Ervin, CFO
(479) 243-2130
Contract Pharmacy Representative
Ellison Family Pharmacy
Levi Ellison, owner
(479) 385-9400
Signed By Date
10/9/2023
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