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MCGEHEE DRUG COMPANY
CH06273G MAINLINE HEALTH SYSTEMS INC
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Covered Entity Details
Entity Name
MAINLINE HEALTH SYSTEMS INC
Subdivision Name
Portland Elementary School Based Clinic
Type
HRSA-Funded Health Center
340B ID
CH06273G
Entity Address
314 Hwy 160 E
Portland, AR 71663
Grant Number
H80CS00638
Participating Start Date
7/1/2016
Last Recertification Date
2/12/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
MCGEHEE DRUG COMPANY
Pharmacy Address
1007 HIGHWAY 65 S
MC GEHEE, AR 71654-9417
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
GARY ALLAN NICHOLS, Executive Director
(870) 538-5414
Contract Pharmacy Representative
sav-mart pharm
Nikki Hood, Owner
(870) 222-6676
Signed By Date
10/16/2023
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