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ARGENTA DRUG CO
DSH040016 UNIVERSITY OF ARKANSAS HOSPITAL
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Covered Entity Details
Entity Name
UNIVERSITY OF ARKANSAS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040016
Entity Address
4301 WEST MARKHAM ST
Slot 571
LITTLE ROCK, AR 72205
Medicare Provider Number
040016
Participating Start Date
12/1/1992
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
ARGENTA DRUG CO
Pharmacy Address
ARGENTA DRUG
324 MAIN ST.
NORTH LITTLE ROCK, AR 72114
Pharmacy Comments
Contract Details
Approval Date
4/4/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/6/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MELISSA FONTAINE, Chief Operating Officer
(501) 686-8955
Contract Pharmacy Representative
David Chu, Owner
(501) 374-4851
Signed By Date
4/4/2013
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