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INFINITY COMPOUNDING SOLUTIONS, LLC
CH062730 MAINLINE HEALTH SYSTEMS INC
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Covered Entity Details
Entity Name
MAINLINE HEALTH SYSTEMS INC
Subdivision Name
MAINLINE HEALTH SYSTEM, INC.
Type
HRSA-Funded Health Center
340B ID
CH062730
Entity Address
233 NORTH MAIN STREET
PORTLAND, AR 71663-0100
Grant Number
H80CS00638
Participating Start Date
12/1/1992
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
INFINITY COMPOUNDING SOLUTIONS, LLC
Pharmacy Address
DBA INFINITY CARE SOLUTIONS
1204 SE 28TH ST STE 2
BENTONVILLE, AR 72712-3887
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GARY ALLAN NICHOLS, Executive Director
(870) 538-5414
Contract Pharmacy Representative
Infinity Compounding Solutions, LLC
Brooke Gaeddert, Corporate Counsel
(479) 265-3144 Ext: 1009
Signed By Date
4/15/2024
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