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ALPS SPECIALTY PHARMACY
DSH040017C NORTH ARKANSAS REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
NORTH ARKANSAS REGIONAL MEDICAL CENTER
Subdivision Name
NEWTON COUNTY FAMILY PRACTICE CLINIC
Type
Disproportionate Share Hospital
340B ID
DSH040017C
Entity Address
502 WEST COURT
JASPER, AR 72641
Medicare Provider Number
040017
Outpatient Facility Provider Number
Participating Start Date
10/1/2010
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
ALPS SPECIALTY PHARMACY
Pharmacy Address
105 S RIDGECREST AVE STE 3A
NIXA, MO 65714
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Josh Bright, Chief Operating Officer
(870) 414-5156
Contract Pharmacy Representative
Food Merchants D/B/A Apls Specialty Pharmacy
Rhonda Flannery, PIC
(417) 719-4510
Signed By Date
7/15/2024
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