340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SCH040047-00 FIVE RIVERS MEDICAL CENTER (Terminated)
Print
Main Details
Name
FIVE RIVERS MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH040047-00
Medicare Provider Number
040047
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2021
Participating Start Date
4/1/2021
Participating Approval Date
3/10/2021
Last Recertification Date
8/29/2022
Termination Date
Termination Reason
10/1/2023
Loss of qualifying hospital status
Contacts
Authorizing Official
Five Rivers Medical Center
Matt Taylor Nichols, CFO
(870) 892-6204
Primary Contact
St. Bernards Medical Center
James Douglas Welborn, Assistant Vice President of Pharmacy Services
(870) 207-1800
Addresses
Street Address
2801 MEDICAL CENTER DRIVE
POCAHONTAS, AR 72455
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
Participating starting 4/1/2015; Terminated 4/1/2020; Reinstated 4/1/2021
03/10/2021
Participating 7/1/2012 through 9/30/2013; not participating 10/1/2013 through 3/31/2015 due to DSH percentage below statutory minimum. Reinstated effective 4/1/2015 based on registration submitted in January 2015.
03/16/2015
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session