Pharmacy Details

SUPER 1 FOODS PHARMACY #628 - information as of 5/23/2025 12:35:28 AM

Name
SUPER 1 FOODS PHARMACY #628

Address

5805 DOLLARWAY RD
PINE BLUFF, AR 71602

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	CH060110	JEFFERSON COMPREHENSIVE CARE SYSTEM, INC.	JEFFERSON COMPREHENSIVE CARE SYSTEM, Inc.	HRSA-Funded Health Center	1101 S Tennessee St		Pine Bluff	AR	10/01/2019	12/31/2022	10/12/2023 3:04 PM
Details	DSH040071	JEFFERSON REGIONAL MEDICAL CENTER		Disproportionate Share Hospital	1600 WEST 40TH AVENUE		PINE BLUFF	AR	04/01/2019	01/03/2023	4/27/2023 4:16 PM
Details	HV00133	JEFFERSON COMPREHENSIVE CARE SYSTEM INC	PINE BLUFF MEDICAL & DENTAL CENTER	Ryan White Part C	1101 S TENNESSEE STREET		PINE BLUFF	AR	10/01/2019	04/01/2025	4/1/2025 12:01 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			SUPER 1 FOODS PHARMACY #628 5805 DOLLARWAY RD PINE BLUFF, AR 71602	9/29/2017 6:44 AM
Addresses	Pharmacy Address	Update		BROOKSHIRE PHARMACY 5805 DOLLARWAY RD PINE BLUFF, AR 71602	SUPER 1 FOODS PHARMACY #628 5805 DOLLARWAY RD PINE BLUFF, AR 71602	3/7/2017 11:01 AM
Details	Name	Update		BROOKSHIRE PHARMACY	SUPER 1 FOODS PHARMACY #628	3/7/2017 11:01 AM
Details	Comments	Insert				3/28/2013 4:23 PM
Details	Is Deleted	Insert			False	3/28/2013 4:23 PM
Addresses	Pharmacy Address	Insert			BROOKSHIRE PHARMACY 5805 DOLLARWAY RD PINE BLUFF, AR 71602	3/28/2013 4:23 PM
Details	Name	Insert			BROOKSHIRE PHARMACY	3/28/2013 4:23 PM