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HARPS PHARMACY #103
CH063730 BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
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Covered Entity Details
Entity Name
BOSTON MOUNTAIN RURAL HEALTH CENTER, INC
Subdivision Name
BOSTON MOUNTAIN RURAL HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH063730
Entity Address
2263 HIGHWAY 65 NORTH
MARSHALL, AR 72650-1030
Grant Number
H80CS00641
Participating Start Date
4/1/2006
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
HARPS PHARMACY #103
Pharmacy Address
703 W MAIN ST
GREEN FOREST, AR 72638-2312
Pharmacy Comments
Contract Details
Approval Date
6/15/2012
Contract Begin Date
6/15/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MELANIE CAMPBELL, EXECUTIVE DIRECTOR
(870) 448-3976
Contract Pharmacy Representative
Jim Antz, CFO
(870) 438-6850
Signed By Date
6/5/2012
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