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WARMACK PHARMACIES INC
CAH041317-00 DALLAS COUNTY MEDICAL CENTER
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Covered Entity Details
Entity Name
DALLAS COUNTY MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH041317-00
Entity Address
201 NORTH CLIFTON ST
FORDYCE, AR 71742
Medicare Provider Number
041317
Participating Start Date
8/23/2010
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
WARMACK PHARMACIES INC
Pharmacy Address
D/B/A RISON PHARMACY
301 MAIN ST
RISON, AR 71665
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ken Sanders, Interim Administrator
(870) 352-6363
Contract Pharmacy Representative
Rison Pharmacy
Lynn Wilson, owner
(870) 325-6262
Signed By Date
10/15/2018
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