340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SUPER D. DRUGS ACQUISITION CO.
DSH040016 UNIVERSITY OF ARKANSAS HOSPITAL
Print
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
SUPER D. DRUGS ACQUISITION CO.
Pharmacy Address
DBA WALGREENS #15792
8815 STAGECOACH ROAD
LITTLE ROCK, AR 72210
Pharmacy Comments
Contract Details
Approval Date
4/11/2014
Contract Begin Date
11/21/2013
Carve-In Effective Date
Contract Comments
04/11/2014 Contract pharmacy restored with begin date adjustment due to ownership change
Contract Termination Date
Termination Reason
1/24/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
MELISSA FONTAINE, Chief Operating Officer
(501) 686-8955
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/14/2014
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session