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WALGREEN CO.
CH06273N MAINLINE HEALTH SYSTEMS INC
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Covered Entity Details
Entity Name
MAINLINE HEALTH SYSTEMS INC
Subdivision Name
Star City High School Clinic
Type
HRSA-Funded Health Center
340B ID
CH06273N
Entity Address
400 E Arkansas St RM E3
Star City, AR 71667-4821
Grant Number
H80CS00638
Participating Start Date
1/1/2018
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #21379
5905 DOLLARWAY RD
PINE BLUFF, AR 71602
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GARY ALLAN NICHOLS, Executive Director
(870) 538-5414
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/16/2023
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