Contract Pharmacy Details

J & K DRUGS
CAH191315-01 HARDTNER MEDICAL CENTER

Covered Entity Details

Entity Name

HARDTNER MEDICAL CENTER

Subdivision Name

HARDTNER MEDICAL CLINIC

Type

Critical Access Hospital

340B ID

CAH191315-01

Entity Address

1049 NORTH PINE RD
OLLA, LA 71465

Medicare Provider Number

191315

Outpatient Facility Provider Number

193456

Participating Start Date

7/1/2015

Last Recertification Date

9/4/2024

Pharmacy Details

Pharmacy Name

J & K DRUGS

Pharmacy Address

7190 HIGHWAY 165
COLUMBIA, LA 71418-3302

Pharmacy Comments

Contract Details

Approval Date

1/15/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Paul G. Mathews, Administrator
(318) 495-3131 Ext: 109

Contract Pharmacy Representative

J&K Drug
George Book, Owner
(318) 649-0825

Signed By Date

1/15/2020