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ARCARE PHARMACY 12
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
ARCARE PHARMACY 12
Pharmacy Address
615 N MAIN ST
BRINKLEY, AR 72021-2507
Pharmacy Comments
Contract Details
Approval Date
7/19/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Stuart Randall Hill, VP Treasurer
(501) 380-1004
Contract Pharmacy Representative
ARcare
TALMAGE J. WHITEHEAD, President/CFO
(870) 347-3414
Signed By Date
7/19/2019
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