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SAM ALEXANDER PHARMACY
CH06373Q 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, Harrison
Type
HRSA-Funded Health Center
340B ID
CH06373Q
Entity Address
1002 North Spring Street
Harrison, AR 72601
Grant Number
H80CS00641
Participating Start Date
7/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SAM ALEXANDER PHARMACY
Pharmacy Address
M&T VENTURES LLC
127 N MAIN ST
HARRISON, AR 72601
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Becky Blair, CFO
(870) 448-5733 Ext: 2008
Contract Pharmacy Representative
Sam Alexander Pharmacy
Matt Willmott, Owner
(870) 741-6511
Signed By Date
10/11/2023
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