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BURROWS REXALL DRUG COMPANY
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
BURROWS REXALL DRUG COMPANY
Pharmacy Address
45 HIGHWAY 64 W
P O BOX 248
BEEBE, AR 72012
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/23/2023
Ownership change
Contacts
Covered Entity Signing Official
Stuart Randall Hill, VP Treasurer
(501) 380-1004
Contract Pharmacy Representative
Burrows Drug Co.
Todd Burrows, Owner
(501) 882-5425
Signed By Date
10/15/2020
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