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MEDIC PHARMACY # 1
CHC00342-00 CABUN RURAL HEALTH SERVICES, INC
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Covered Entity Details
Entity Name
CABUN RURAL HEALTH SERVICES, INC
Subdivision Name
CABUN Rural Health Services, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC00342-00
Entity Address
402 LEE ST
HAMPTON, AR 71744
Grant Number
H80CS00342
Participating Start Date
10/1/2009
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
MEDIC PHARMACY # 1
Pharmacy Address
347 W OAK ST
EL DORADO, AR 71730-4564
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MELANIE SHEPPARD, CEO
(870) 798-4064 Ext: 2227
Contract Pharmacy Representative
Medic Pharmacy #1
Richard Hanry, Owner
(870) 862-4931
Signed By Date
10/15/2020
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