340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MEDICINE MAN PHARMACY SPRINGHILL
DSH040036 BAPTIST HEALTH MEDICAL CENTER- NLR
Print
Covered Entity Details
Entity Name
BAPTIST HEALTH MEDICAL CENTER- NLR
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040036
Entity Address
3333 SPRINGHILL DRIVE
NORTH LITTLE ROCK, AR 72117
Medicare Provider Number
040036
Participating Start Date
10/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
MEDICINE MAN PHARMACY SPRINGHILL
Pharmacy Address
3201 SPRINGHILL DR STE 110
NORTH LITTLE ROCK, AR 72117-2910
Pharmacy Comments
Contract Details
Approval Date
7/18/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brent Beaulieu, CFO
(501) 202-2017
Contract Pharmacy Representative
Medicine Man Pharmacy
Terry Perkins, Owner
(501) 758-7581
Signed By Date
7/12/2024
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