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AMERICAN HOME PHARMACY LLC
CH06373H 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 - South Side School Based Health Center
Type
HRSA-Funded Health Center
340B ID
CH06373H
Entity Address
326 South Side Road
Bee Branch, AR 72013
Grant Number
H80CS00641
Participating Start Date
1/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
AMERICAN HOME PHARMACY LLC
Pharmacy Address
454 INGRAM ST
CLINTON, AR 72031
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
American Home Pharmacy LLC
Josh Langston, Contact
(501) 745-4266
Signed By Date
10/11/2023
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