340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WHITE HALL PHARMACY LLC, DBA DOCTOR'S OR
DSH040071 JEFFERSON REGIONAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
JEFFERSON REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH040071
Entity Address
1600 WEST 40TH AVENUE
PINE BLUFF, AR 71603
Medicare Provider Number
040071
Participating Start Date
4/1/2000
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
WHITE HALL PHARMACY LLC, DBA DOCTOR'S OR
Pharmacy Address
7240 SHERIDAN RD STE 102
WHITE HALL, AR 71602-3224
Pharmacy Comments
Contract Details
Approval Date
5/7/2012
Contract Begin Date
5/22/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/20/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
BRYAN JACKSON, CHIEF ADMINISTRATIVE OFFICER
(870) 541-7141
Contract Pharmacy Representative
Whitehall Pharmacy, LLC.
Lelan Stice, Owner
(870) 850-8010
Signed By Date
5/16/2012
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