340B Drug Pricing Program Database

Pharmacy Name

PRESCRIPTION SHOP DBA J&B KELLY, INC

Pharmacy Address

202 S LIVERMORE
HAZEN, AR 72064

Pharmacy Comments

Approval Date

11/17/2009

Contract Begin Date

11/17/2009

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/19/2018
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official


Contract Pharmacy Representative

BYRUM KELLY, OWNER
(870) 255-4403

Signed By Date

10/23/2009