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PHARM Z LLC
DSH040014 WHITE COUNTY MEDICAL CENTER
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Covered Entity Details
Entity Name
WHITE COUNTY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040014
Entity Address
3214 East Race Avenue
SEARCY, AR 72143
Medicare Provider Number
040014
Participating Start Date
4/1/2015
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
PHARM Z LLC
Pharmacy Address
BURROW'S DRUG STORE
45 HWY 64 W
BEEBE, AR 72012
Pharmacy Comments
Contract Details
Approval Date
12/21/2023
Contract Begin Date
12/21/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stuart Randall Hill, VP Treasurer
(501) 380-1004
Contract Pharmacy Representative
Burrow's Drug Store
Zakary Kendrick, Owner
(501) 882-5425
Signed By Date
12/21/2023
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