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PALACE DRUG OF SALEM
CH06372E 1ST CHOICE HEALTHCARE, INC.
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Covered Entity Details
Entity Name
1ST CHOICE HEALTHCARE, INC.
Subdivision Name
1st Choice Healthcare Salem
Type
HRSA-Funded Health Center
340B ID
CH06372E
Entity Address
172 Hwy 62 and 412
Salem, AR 72576
Grant Number
H80CS00537
Participating Start Date
1/1/2018
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
PALACE DRUG OF SALEM
Pharmacy Address
PALACE DRUG OF SALEM LLC
106 HIGHWAY 62 W
SALEM, AR 72576
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
BRIGITTE MCDONALD, Chief Executive Officer
(870) 857-3334 Ext: 302
Contract Pharmacy Representative
Palace Drug
MJ Clark, Pharmacy Director
(870) 625-3222
Signed By Date
10/11/2023
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