Contract Pharmacy Details

CLINTON DRUG
CH06373A BOSTON MOUNTAIN RURAL HEALTH CENTER, INC

Covered Entity Details

Entity Name

BOSTON MOUNTAIN RURAL HEALTH CENTER, INC

Subdivision Name

BMRHC-Clinton Clinic

Type

HRSA-Funded Health Center

340B ID

CH06373A

Entity Address

465 MEDICAL CENTER PARKWAY
CLINTON, AR 72031

Grant Number

H80CS00641

Participating Start Date

4/1/2006

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

CLINTON DRUG

Pharmacy Address

2526 HWY 65 SOUTH, SUITE 101
CLINTON, AR 72031

Pharmacy Comments

Contract Details

Approval Date

4/11/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/11/2018
Agreement registered in error

Contacts

Covered Entity Signing Official

Becky Blair, CFO
(870) 448-5733 Ext: 2008

Contract Pharmacy Representative

Clinton Drug
Michael Butler, Owner
(501) 620-4053

Signed By Date

4/11/2018