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ALLCARE SPECIALTY PHARMACY, LLC
DSH040114 BAPTIST HEALTH MEDICAL CENTER - LR
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Covered Entity Details
Entity Name
BAPTIST HEALTH MEDICAL CENTER - LR
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040114
Entity Address
9601 Baptist Health Drive
LITTLE ROCK, AR 72205
Medicare Provider Number
040114
Participating Start Date
10/1/2015
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
ALLCARE SPECIALTY PHARMACY, LLC
Pharmacy Address
10620 COLONEL GLENN RD STE 300
LITTLE ROCK, AR 72204-8048
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brent Beaulieu, CFO
(501) 202-2017
Contract Pharmacy Representative
ALLCARE SPECIALTY PHARMACY, LLC
Mark Adkison, President
(501) 217-8880
Signed By Date
10/15/2019
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