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WALGREEN CO.
CAH041321-00 BAPTIST HEALTH MEDICAL CENTER - ARKADELPHIA
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Covered Entity Details
Entity Name
BAPTIST HEALTH MEDICAL CENTER - ARKADELPHIA
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH041321-00
Entity Address
3050 TWIN RIVERS DRIVE
ARKADELPHIA, AR 71923-4299
Medicare Provider Number
041321
Participating Start Date
1/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 10365
308 S MAIN STREET
MALVERN, AR 72104-3790
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brent Beaulieu, CFO
(501) 202-2017
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2019
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