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JEPSON DRUG STORE INC
CH0619500 ST. FRANCIS HOUSE NWA, INC.
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Covered Entity Details
Entity Name
ST. FRANCIS HOUSE NWA, INC.
Subdivision Name
Community Clinic Springdale Medical
Type
HRSA-Funded Health Center
340B ID
CH0619500
Entity Address
614 E Emma Ave STE 300
Springdale, AR 72764-4469
Grant Number
H80CS04290
Participating Start Date
4/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
JEPSON DRUG STORE INC
Pharmacy Address
JEPSON DRUG IS DBA NAME
623 S MOUNT OLIVE ST
SILOAM SPRINGS, AR 72761
Pharmacy Comments
Contract Details
Approval Date
4/11/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Semingson II, Chief Executive Officer
(479) 751-7417 Ext: 6070
Contract Pharmacy Representative
Jepson Drug Stor
Corey Rhodes, Manager
(479) 524-4311
Signed By Date
4/11/2024
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