340B Drug Pricing Program Database
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RRC040010-11 MERCY MEDICAL CENTER (Active)
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Main Details
Name
MERCY MEDICAL CENTER
Subdivision Name
MERCY HOSPITAL ROGERS - Mammography Highway 102
Type
Rural Referral Center
Rural
No
340B ID
RRC040010-11
Medicare Provider Number
040010
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2024
Participating Start Date
10/1/2024
Participating Approval Date
9/12/2024
Last Recertification Date
Contacts
Authorizing Official
Mercy
Greta Wilcher, Vice-President Finance
(479) 314-6100 Ext: 6104
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
3101 SOUTHEAST 14TH STREET
BENTONVILLE, AR 72712-4900
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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