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36C25620Q0078 P09 Attachment 6 Pharmacies to Proximity of Clinics.docx
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VA256-17-Q-0277
Attachment 6
PHARMACIES TO PROXIMITY OF CLINIC’S.
List of Pharmacies to Proximity of Clinic’s. This is to be filled out and returned with Offer.
| CBOC Location: |
| Fort Smith Community Based Outpatient Clinic |
1500 Dodson Avenue
Fort Smith AR 72901
Offeror shall provide the following information for the CBOC with his/her offer.
| Name, Address, and Phone # of |
| Handicapped |
| Distance |
| Drive-up |
| Hours and |
| Normal |
Dispensing Pharmacy
| Accessible? |
| from clinic |
| Window |
| Days of |
| Waiting Time |
| Yes or No |
| (# of miles) |
| Available |
| Operation |
| to Fill |
Yes or No
Prescriptions
| CBOC Location: |
| Harrison Community Based Outpatient Clinic |
707 N Main St
Harrison AR 72601
Offeror shall provide the following information for the CBOC with his/her offer.
| Name, Address, and Phone # of |
| Handicapped |
| Distance |
| Drive-up |
| Hours and |
| Normal |
Dispensing Pharmacy
| Accessible? |
| from clinic |
| Window |
| Days of |
| Waiting Time |
| Yes or No |
| (# of miles) |
| Available |
| Operation |
| to Fill |
Yes or No
Prescriptions
| CBOC Location: |
| Branson Community Based Outpatient Clinic |
5571 Gretna
Branson MO 65616
Offeror shall provide the following information for the CBOC with his/her offer.
| Name, Address, and Phone # of |
| Handicapped |
| Distance |
| Drive-up |
| Hours and |
| Normal |
Dispensing Pharmacy
| Accessible? |
| from clinic |
| Window |
| Days of |
| Waiting Time |
| Yes or No |
| (# of miles) |
| Available |
| Operation |
| to Fill |
Yes or No
Prescriptions
| CBOC Location: |
| Jay Community Based Outpatient Clinic |
1569 N. Main St
Jay, Oklahoma 72346
Offeror shall provide the following information for the CBOC with his/her offer.
| Name, Address, and Phone # of |
| Handicapped |
| Distance |
| Drive-up |
| Hours and |
| Normal |
Dispensing Pharmacy
| Accessible? |
| from clinic |
| Window |
| Days of |
| Waiting Time |
| Yes or No |
| (# of miles) |
| Available |
| Operation |
| to Fill |
Yes or No
Prescriptions
| CBOC Location: |
| Ozark Community Based Outpatient Clinic |
2713 West Commercial
Ozark, AR 72949
Offeror shall provide the following information for the CBOC with his/her offer.
| Name, Address, and Phone # of |
| Handicapped |
| Distance |
| Drive-up |
| Hours and |
| Normal |
Dispensing Pharmacy
| Accessible? |
| from clinic |
| Window |
| Days of |
| Waiting Time |
| Yes or No |
| (# of miles) |
| Available |
| Operation |
| to Fill |
Yes or No
Prescriptions
| CBOC Location: |
| Fayetteville Veterans Affairs Medical Center |
1100 N. College Ave.
Fayetteville, AR 72703
Offeror shall provide the following information for the CBOC with his/her offer.
| Name, Address, and Phone # of |
| Handicapped |
| Distance |
| Drive-up |
| Hours and |
| Normal |
Dispensing Pharmacy
| Accessible? |
| from clinic |
| Window |
| Days of |
| Waiting Time |
| Yes or No |
| (# of miles) |
| Available |
| Operation |
| to Fill |
Yes or No
Prescriptions
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