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MITCHELL'S DRUG STORES ON THE BOULEVARD
CH074490 OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
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Covered Entity Details
Entity Name
OZARK TRI-COUNTY HEALTH CARE CONSORTIUM
Subdivision Name
ACCESS Family Care Administration
Type
HRSA-Funded Health Center
340B ID
CH074490
Entity Address
475 Nelson Ave.
Neosho, MO 64850-9120
Grant Number
H80CS00673
Participating Start Date
1/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MITCHELL'S DRUG STORES ON THE BOULEVARD
Pharmacy Address
TIM MITCHELL MEDICAL INC
719 S. NEOSHO BLVD
SUITE A
NEOSHO, MO 64850-2007
Pharmacy Comments
Contract Details
Approval Date
4/26/2012
Contract Begin Date
4/26/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/18/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Don McBride, CEO
(417) 451-9450 Ext: 212
Contract Pharmacy Representative
Tim Mitchell, Owner
(417) 451-9501
Signed By Date
4/26/2012
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