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PRESCRIPTIONS CORNER DRUG
DSH040039 ARKANSAS METHODIST MEDICAL CENTER
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Covered Entity Details
Entity Name
ARKANSAS METHODIST MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040039
Entity Address
900 WEST KINGS HIGHWAY
PARAGOULD, AR 72450
Medicare Provider Number
040039
Participating Start Date
1/1/2024
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
PRESCRIPTIONS CORNER DRUG
Pharmacy Address
PRESCRIPTIONS CORNER DRUG INC
320 W KINGSHIGHWAY
PARAGOULD, AR 72450-7245
Pharmacy Comments
Contract Details
Approval Date
10/24/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Staci J Williams, CFO
(870) 239-7105
Contract Pharmacy Representative
Prescriptions Corner Drug
Robert Hodge, Owner
(870) 239-9535
Signed By Date
10/12/2023
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