340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DELTA DRUG OF DERMOTT INC
CH06273F MAINLINE HEALTH SYSTEMS INC
Print
Covered Entity Details
Entity Name
MAINLINE HEALTH SYSTEMS INC
Subdivision Name
Star City Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH06273F
Entity Address
110 N Drew St
Star City, AR 71667-5704
Grant Number
H80CS00638
Participating Start Date
7/1/2014
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
DELTA DRUG OF DERMOTT INC
Pharmacy Address
111 E PEDDICORD ST
DERMOTT, AR 71638
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
7/26/2019
Agreement registered in error
Contacts
Covered Entity Signing Official
GARY ALLAN NICHOLS, Executive Director
(870) 538-5414
Contract Pharmacy Representative
Pharmacy
JEFF F. DUNN, OWNER/PHARMACIST
(870) 538-5510
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