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DELTA DRUG OF DERMOTT INC
CAH041308-00 MCGEHEE HOSPITAL INC.
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Covered Entity Details
Entity Name
MCGEHEE HOSPITAL INC.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH041308-00
Entity Address
900 South 3rd
MCGEHEE, AR 71654
Medicare Provider Number
041308
Participating Start Date
10/1/2017
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
DELTA DRUG OF DERMOTT INC
Pharmacy Address
111 E PEDDICORD ST
DERMOTT, AR 71638
Pharmacy Comments
Contract Details
Approval Date
4/12/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John E. Heard, CEO
(870) 222-8900
Contract Pharmacy Representative
Delta Drug of Dermott
Jeff Dunn, Owner
(870) 538-5510
Signed By Date
4/12/2018
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