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EAST END PHARMACY
CH06273AG MAINLINE HEALTH SYSTEMS INC
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Covered Entity Details
Entity Name
MAINLINE HEALTH SYSTEMS INC
Subdivision Name
Warren Elementary School Clinic
Type
HRSA-Funded Health Center
340B ID
CH06273AG
Entity Address
2018 Lady Jack Drive
Warren, AR 71671
Grant Number
H80CS00638
Participating Start Date
1/1/2024
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
EAST END PHARMACY
Pharmacy Address
20381 ARCH ST
LITTLE ROCK, AR 72206-9218
Pharmacy Comments
Contract Details
Approval Date
1/8/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GARY ALLAN NICHOLS, Executive Director
(870) 538-5414
Contract Pharmacy Representative
East End Pharmacy
Shane Greene, Pharmacy contact
(501) 888-2830
Signed By Date
1/8/2024
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