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GIBSON'S PHARMACY OF CRAIGHEAD COUNTY IN
DSH040020 ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER
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Covered Entity Details
Entity Name
ST BERNARDS HOSPITAL INC DBA ST BERNARDS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040020
Entity Address
225 East Washington AVENUE
JONESBORO, AR 72401
Medicare Provider Number
040020
Participating Start Date
7/1/2006
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
GIBSON'S PHARMACY OF CRAIGHEAD COUNTY IN
Pharmacy Address
GIBSONS PHARMACY OF CRAIGHEAD CO INC
403 E MATTHEWS AVE
JONESBORO, AR 72401-3142
Pharmacy Comments
06/20/2012 Change name (was Gibson's Pharmacy of Jonesboro)
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Benjamin F Barylske, VP of Finance / CFO
(870) 207-4565
Contract Pharmacy Representative
Bryant's Pharmacy & Health Care Center
Steve Bryant, President
(870) 793-3999
Signed By Date
1/17/2023
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