340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FRED'S PHARMACY #2371
CH06273D MAINLINE HEALTH SYSTEMS INC
Print
Covered Entity Details
Entity Name
MAINLINE HEALTH SYSTEMS INC
Subdivision Name
Monticello Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH06273D
Entity Address
535 Jordan Dr.
Monticello, AR 71655-5714
Grant Number
H80CS00638
Participating Start Date
10/1/2012
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
FRED'S PHARMACY #2371
Pharmacy Address
406 HIGHWAY 425 SOUTH
MONTICELLO, AR 71655
Pharmacy Comments
Contract Details
Approval Date
1/14/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/27/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
GARY ALLAN NICHOLS, Executive Director
(870) 538-5414
Contract Pharmacy Representative
Fred's Pharmacy
Nicole Pearson, 340B Program Manager
(901) 500-6153
Signed By Date
1/14/2018
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