340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
JASPER PHARMACY
DSH040017C NORTH ARKANSAS REGIONAL MEDICAL CENTER
Print
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
JASPER PHARMACY
Pharmacy Address
200 WEST CHURCH ST
P.O. BOX 520
JASPER, AR 72641
Pharmacy Comments
Contract Details
Approval Date
10/15/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/18/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Richard McBryde, COO
(870) 414-5156
Contract Pharmacy Representative
Leah Henderson, Owner
(870) 446-5515
Signed By Date
10/15/2014
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