340B Drug Pricing Program Database
ACHOR FAMILY PHARMACY, LLC
DSH040114 BAPTIST HEALTH MEDICAL CENTER - LR - information as of 4/30/2025 11:13:45 PM
Covered Entity Details
Entity Name
BAPTIST HEALTH MEDICAL CENTER - LR
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040114
Entity Address
9601 Baptist Health Drive
LITTLE ROCK, AR 72205
Medicare Provider Number
040114
Participating Start Date
10/1/2015
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
ACHOR FAMILY PHARMACY, LLC
Pharmacy Address
1900 CLUB MANOR DR STE 101
MAUMELLE, AR 72113-7443
Pharmacy Comments
Contract Details
Approval Date
4/7/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brent Beaulieu, CFO
(501) 202-2017
Contract Pharmacy Representative
Achor Family Pharmacy, LLC
Brandon Achor, Member/PIC
(501) 274-1130
Signed By Date
4/7/2025
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