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MITCHELL'S DOWNTOWN DRUG STORE
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 DOWNTOWN DRUG STORE
Pharmacy Address
115 E HICKORY ST
NEOSHO, MO 64850-1806
Pharmacy Comments
Contract Details
Approval Date
10/15/2016
Contract Begin Date
1/1/2017
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 MEDICAL INC
Tim Mitchell, Owner
(417) 451-9501
Signed By Date
10/15/2016
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