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STANLEY PHARMACY
DSH040014 WHITE COUNTY MEDICAL CENTER
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Covered Entity Details
Entity Name
WHITE COUNTY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040014
Entity Address
3214 East Race Avenue
SEARCY, AR 72143
Medicare Provider Number
040014
Participating Start Date
4/1/2015
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
STANLEY PHARMACY
Pharmacy Address
2007 W BEEBE CAPPS EXPY
STAN-KEL PHARMACIES, INC
SEARCY, AR 72143-5014
Pharmacy Comments
Contract Details
Approval Date
1/9/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stuart Randall Hill, VP Treasurer
(501) 380-1004
Contract Pharmacy Representative
Stanley and Turner Drug Company
Scott Stanley, Owner
(501) 281-1374
Signed By Date
1/9/2019
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