340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KROGER PHARMACY #465
DSH040020 ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER
Print
Covered Entity Details
Entity Name
ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040020
Entity Address
225 East Washington AVENUE
JONESBORO, AR 72401
Medicare Provider Number
040020
Participating Start Date
7/1/2006
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #465
Pharmacy Address
400 WEST MOULTRIE
BLYTHEVILLE, AR 72315
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Benjamin F Barylske, VP of Finance / CFO
(870) 207-4565
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
4/15/2019
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