Contract Pharmacy Details

SUPER D DRUGS ACQUISITION CO.
CH06014B EAST ARKANSAS FAMILY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

EAST ARKANSAS FAMILY HEALTH CENTER, INC.

Subdivision Name

Healthy Partners

Type

HRSA-Funded Health Center

340B ID

CH06014B

Entity Address

4102 Memorial Drive
Blytheville, AR 72315

Grant Number

H80CS00123

Participating Start Date

1/1/2011

Last Recertification Date

2/8/2017

Entity Termination Date

1/1/2018

Pharmacy Details

Pharmacy Name

SUPER D DRUGS ACQUISITION CO.

Pharmacy Address

DBA: WALGREENS #15788
900 N 6TH STREET
BLYTHEVILLE, AR 72315-2714

Pharmacy Comments

Contract Details

Approval Date

1/13/2011

Contract Begin Date

1/13/2011

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2018
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Susan Ward-Jones, CEO
(870) 732-6520

Contract Pharmacy Representative

GALEN PERKINS, DIRECTOR OF PHARMACY SERVICES
(501) 296-3311

Signed By Date

11/3/2010

340B Drug Pricing Program Database