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WAGNER'S MOUNT IDA PHARMACY
CH061220N HEALTHY CONNECTIONS INC
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Covered Entity Details
Entity Name
HEALTHY CONNECTIONS INC
Subdivision Name
Mount Ida School Based Health Center-Elementary Campus
Type
HRSA-Funded Health Center
340B ID
CH061220N
Entity Address
430 Ball Park Rd
Mount Ida, AR 71957
Grant Number
H80CS00279
Participating Start Date
4/1/2020
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WAGNER'S MOUNT IDA PHARMACY
Pharmacy Address
WAGNER DRUGS
744 HIGHWAY 270 E
PO BOX 66
MOUNT IDA, AR 71957-8003
Pharmacy Comments
Contract Details
Approval Date
3/9/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tony Calandro, CEO
(479) 437-3449 Ext: 181
Contract Pharmacy Representative
Mt Ida Pharmacy
Laura Wagner, Owner
(870) 867-3174
Signed By Date
1/15/2020
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