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EAST END PHARMACY
CH062730 MAINLINE HEALTH SYSTEMS INC
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Covered Entity Details
Entity Name
MAINLINE HEALTH SYSTEMS INC
Subdivision Name
MAINLINE HEALTH SYSTEM, INC.
Type
HRSA-Funded Health Center
340B ID
CH062730
Entity Address
233 NORTH MAIN STREET
PORTLAND, AR 71663-0100
Grant Number
H80CS00638
Participating Start Date
12/1/1992
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
EAST END PHARMACY
Pharmacy Address
20381 ARCH ST
LITTLE ROCK, AR 72206-9218
Pharmacy Comments
Contract Details
Approval Date
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GARY ALLAN NICHOLS, Executive Director
(870) 538-5414
Contract Pharmacy Representative
East End Pharmacy
Shane Green, Representative
(501) 888-2830
Signed By Date
4/14/2022
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