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PED043300-00 ARKANSAS CHILDRENS HOSPITAL (Active)
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Main Details
Name
ARKANSAS CHILDRENS HOSPITAL
Subdivision Name
Type
Children's Hospital
Rural
No
340B ID
PED043300-00
Medicare Provider Number
043300
Additional Details
Current Program Status
Active
Registration Date
1/10/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/25/2020
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
Arkansas Children's
Gena Wingfield, Chief Financial Officer/Executive Vice President
(501) 364-2555
Primary Contact
Arkansas Children's Hospital
Kendrea M Jones, Director of Pharmacy
(501) 364-1869
Addresses
Street Address
1 CHILDRENS WAY
LITTLE ROCK, AR 72202
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated started 1/1/2020, terminated 1/1/2020. Reinstated 4/1/2020.
01/23/2020
May 2025
May 2025
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