Contract Pharmacy Details

D&D PHARMACY LLC
CH060110 JEFFERSON COMPREHENSIVE CARE SYSTEM, INC.

Covered Entity Details

Entity Name

JEFFERSON COMPREHENSIVE CARE SYSTEM, INC.

Subdivision Name

JEFFERSON COMPREHENSIVE CARE SYSTEM, Inc.

Type

HRSA-Funded Health Center

340B ID

CH060110

Entity Address

1101 S Tennessee St
Pine Bluff, AR 71601-5801

Grant Number

H80CS00727

Participating Start Date

1/1/2007

Last Recertification Date

3/7/2025

Pharmacy Details

Pharmacy Name

D&D PHARMACY LLC

Pharmacy Address

8908 KANIS ROAD, SUITE 350
LITTLE ROCK, AR 72205

Pharmacy Comments

Contract Details

Approval Date

7/15/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Sandra J. Brown, Chief Executive Officer
(870) 543-2300

Contract Pharmacy Representative

D & D Pharmacy, LLC
Laticia Dittrich, Owner
(501) 228-2201

Signed By Date

7/15/2019

340B Drug Pricing Program Database