Covered Entity Details

CH06362AF VARIETY CARE, INC. (Approved) - information as of 5/5/2025 12:00:11 AM

Main Details

Name

VARIETY CARE, INC.

Subdivision Name

Variety Care Turtle Creek-Edmond

Type

HRSA-Funded Health Center

Site ID

BPS-H80-040043

340B ID

CH06362AF

Grant Number

H80CS00543

Additional Details

Current Program Status

Approved

Registration Date

4/15/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/17/2025

Last Recertification Date

Contacts

Authorizing Official

Variety Care, Inc.
LOU CARMICHAEL, CEO
(405) 636-1675

Primary Contact

Variety Care
Mickey Phan, Director of Pharmacy
(405) 632-6688 Ext: 10150

Addresses

Street Address

2000 E 15th St, Suite 400A
Edmond, OK 73013-6673

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH063620	Active	BPS-H80-000950	Variety Care	Variety Care - Straka Family Health Center	1025 Straka Ter	Oklahoma City	OK
CH06362AA	Approved	BPS-H80-038009	VARIETY CARE, INC.	Variety Care Crooked Oak Family Health Center	1450 S. Eastern Ave. BLDG A	Oklahoma City	OK
CH06362AB	Approved	BPS-H80-039965	VARIETY CARE, INC.	Variety Care Clinton	316 S 4th St	Clinton	OK
CH06362AC	Approved	BPS-H80-038008	VARIETY CARE, INC.	Variety Care Hobart	1000 S Broadway Ave	Hobart	OK
CH06362AD	Approved	BPS-H80-036823	VARIETY CARE, INC.	Variety Care Mobile Dental Van #2	718 W Petree Rd	Anadarko	OK
CH06362AE	Approved	BPS-H80-030214	VARIETY CARE, INC.	Variety Care Mobile Van #1	1025 Straka Ter	Oklahoma City	OK
CH06362AF	Approved	BPS-H80-040043	VARIETY CARE, INC.	Variety Care Turtle Creek-Edmond	2000 E 15th St, Suite 400A	Edmond	OK
CH06362B	Active	BPS-H80-002486	Variety Care, Inc.	Variety Care - Ft. Cobb Health Center	111 W. MAIN STREET	FT. COBB	OK
CH06362C	Active	BPS-H80-009177	Variety Care, Inc.	Variety Care Mid-Del Family Health Center	3851 Tinker Diagonal	Del City	OK
CH06362D	Active	BPS-H80-009193	Variety Care, Inc.	Variety Care - Inasmuch Pediatric & Wellness Center	500 SW 44th	Oklahoma City	OK
CH06362F	Active	BPS-H80-008809	Variety Care, Inc.	Variety Care Tenth Street Family Medical Center	4023 NW 10th St	Oklahoma City	OK
CH06362G	Terminated	BPS-H80-010031	Variety Care, Inc.	Variety Care Big Pasture Health Center at Grandfield	203 W 2nd St	Grandfield	OK
CH06362H	Active	BPS-H80-013431	Variety Care, Inc.	Variety Care Pediatric Center on North Portland	5320 N. Portland Ave.	Oklahoma City	OK
CH06362J	Active	BPS-H80-017945	Variety Care, Inc.	Variety Care Women and Children Norman	1237 Alameda	Norman	OK
CH06362K	Active	BPS-H80-012834	Variety Care, Inc.	Variety Care Norman	317 Himes	Norman	OK
CH06362L	Terminated	BPS-H80-011973	OKLAHOMA COMMUNITY HEALTH SERVICES, INC.	Variety Care - Thomas	100 S 2nd St	Thomas	OK
CH06362M	Active	BPS-H80-014710	VARIETY CARE, INC.	Variety Care at Big Pasture	201 W 1ST ST	GRANDFIELD	OK
CH06362N	Terminated	BPS-H80-015437	VARIETY CARE, INC.	Variety Care Northwest Oklahoma City	2208 W HEFNER RD	OKLAHOMA CITY	OK
CH06362P	Terminated	BPS-H80-012693	VARIETY CARE, INC.	Variety Care at Capitol Hill High School	500 SW 36th Street	Oklahoma City	OK
CH06362Q	Active	BPS-H80-018830	VARIETY CARE, INC.	Variety Care, General Pershing Wellness Campus	2617 General Pershing Blvd	Oklahoma City	OK
CH06362R	Terminated	BPS-H80-018409	VARIETY CARE, INC.	Variety Care at OSU-OKC	440 N. Portland Ave.	Oklahoma City	OK
CH06362S	Active	BPS-H80-019062	Variety Care, Inc.	Britton Health Center	721 W. Britton Rd.	Oklahoma City	OK
CH06362T	Active	BPS-H80-030715	Variety Care, Inc.	Variety Care Anadarko	718 W Petree Rd	Anadarko	OK
CH06362U	Active	BPS-H80-032112	Variety Care, Inc.	Variety Care Baptist Portland	5401 N Portland Ave Ste 500	Oklahoma City	OK
CH06362V	Active	BPS-H80-030512	Variety Care, Inc.	Variety Care - Reno	4000 W Reno Ave	Oklahoma City	OK
CH06362W	Active	BPS-H80-024996	Variety Care, Inc.	Variety Care at Pete White Health and Wellness Center	4021 S Walker Ave Ste 201	Oklahoma City	OK
CH06362X	Active	BPS-H80-030927	Variety Care, Inc.	Variety Care - Yukon	508 W Vandament Ave Ste 210	Yukon	OK
CH06362Y	Active	BPS-H80-035189	Variety Care, Inc.	Variety Care - Putnam North	11220 N Rockwell Ave	Oklahoma City	OK
CH06362Z	Active	BPS-H80-032594	Variety Care, Inc.	Variety Care at Sequoyah	2400 NW 36th St Ste 100	Oklahoma City	OK

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH063620	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	07/01/2024
CH063620	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	07/01/2024
CH063620	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	07/01/2024
CH063620	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	07/01/2024
CH063620	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	07/01/2024
CH063620	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	07/01/2024
CH063620	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	07/01/2022
CH063620	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	07/01/2022
CH063620	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	07/01/2022
CH063620	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	07/01/2022
CH063620	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	07/01/2022
CH063620	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	07/01/2022
CH063620	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	07/01/2022
CH063620	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	07/01/2022
CH063620	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	07/01/2022
CH063620	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	07/01/2022
CH063620	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	04/01/2022
CH063620	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	04/01/2022
CH063620	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	07/01/2022
CH063620	CYSTIC FIBROSIS SERVICES	CYSTIC FIBROSIS SERVICES, INC	10530 JOHN W ELLIOTT DR, STE 200	FRISCO	TX	75033	07/01/2016	08/09/2017
CH063620	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2017
CH063620	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	07/01/2024
CH063620	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	07/01/2024
CH063620	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	07/01/2024
CH063620	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	07/01/2024
CH063620	FIKES PHARMACY	101 EAST 2ND STREET		GRANDFIELD	OK	73546-0159	04/01/2013
CH063620	FREDERICK PHARMACY	1600 N MAIN ST	P O BOX 981	FREDERICK	OK	73542-1419	01/01/2015
CH063620	GOOD HEALTH INC	DBA PREMIER PHARMACY SERVICES	1943 SCHUETZ RD	SAINT LOUIS	MO	63146-3550	07/01/2022
CH063620	HUNTER'S PRECISION RX	10120 BROADWAY EXTENSION	SUITE 120	OKLAHOMA CITY	OK	73114	12/06/2010	06/21/2016
CH063620	HUNTER'S SPECIALTY PHARMACY	10120 BROADWAY EXT	SUITE 100	OKLAHOMA CITY	OK	73114	12/02/2010	06/21/2016
CH063620	LIBERTY DRUG	15 W. MAIN ST		CARNEGIE	OK	73015	01/01/2015
CH06362B	LIBERTY DRUG	15 W. MAIN ST		CARNEGIE	OK	73015	04/16/2010
CH06362H	LOVELL'S PHARMACY	602 W CENTRAL BLVD		ANADARKO	OK	73005-3228	01/01/2021
CH063620	NORTHROCK PHARMACY	2617 GENERAL PERSHING BLVD		OKLAHOMA CITY	OK	73107	04/01/2025
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05959	900 SW 44TH ST	OKLAHOMA CITY	OK	73109	01/01/2020
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06004	9401 NORTH PENNSYLVANIA AVE.	THE VILLAGE	OK	73120	01/01/2020
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06016	9001 S WESTERN AVE	OKLAHOMA CITY	OK	73139	01/01/2020
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06231	4500 NW 23RD ST	OKLAHOMA CITY	OK	73127	01/01/2020
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02271	3501 NW 36TH AVE.	NORMAN	OK	73072	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06024	1100 E. LINDSEY ST.	NORMAN	OK	73071	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06109	2350 N. HARPER ST., POBOX1009	CHOCTAW	OK	73020	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 10520	2107 NW CACHE ROAD	LAWTON	OK	73505	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06015	4251 SE 44TH ST	DEL CITY	OK	73135	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02489	100 S. DOUGLAS BLVD.	MIDWEST CITY	OK	73130	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06009	5025 N. MAY AVE.	OKLAHOMA CITY	OK	73112	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	CVS/PHARMACY # 11092	15103 N MACARTHUR BLVD	OKLAHOMA CITY	OK	73013	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	CVS PHARMACY # 16007	5400 N MAY AVE	OKLAHOMA CITY	OK	73112	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06235	106 W HWY 152	MUSTANG	OK	73064	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 08312	201 S. MUSTANG RD.	YUKON	OK	73099	10/01/2021
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03883	9000 S. MAY AVE.	OKLAHOMA CITY	OK	73159	01/01/2022
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06022	12301 N MAY AVE	OKLAHOMA CITY	OK	73120	01/01/2022
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06010	2412 N CLASSEN BLVD	OKLAHOMA CITY	OK	73106	01/01/2022
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06003	4026 N MACARTHUR BLVD	WARR ACRES	OK	73122	01/01/2022
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06128	1016 SW LEE BLVD	LAWTON	OK	73501	07/01/2022
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06232	110 W VANDAMENT AVE	YUKON	OK	73099	07/01/2022
CH063620	OKLAHOMA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06225	1520 S. BRYANT AVE.	EDMOND	OK	73013	07/01/2025
CH063620	OPTUM INFUSION SERVICES 305, LLC	15529 COLLEGE BLVD.		LENEXA	KS	66219-1351	07/01/2024
CH063620	OPTUM INFUSION SERVICES 550, LLC	20 COMMERCE WAY	SUITE 2	WOBURN	MA	01801	07/01/2024
CH063620	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	07/01/2024
CH063620	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	07/01/2024
CH063620	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	07/01/2024
CH063620	OPTUM PHARMACY 701, LLC	4015 SHOPTON RD STE 600		CHARLOTTE	NC	28217-3025	07/01/2024
CH063620	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	07/01/2024
CH063620	OPTUM PHARMACY 701, LLC	8131 W BOSTIAN RD STE A350		WOODINVILLE	WA	98072-5029	07/01/2024
CH063620	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	07/01/2024
CH063620	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	07/01/2024
CH063620	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	07/01/2024
CH063620	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	07/01/2024
CH063620	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	07/01/2024
CH063620	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	07/01/2024
CH063620	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	07/01/2024
CH063620	PHYSICIANS & SURGEONS PHY INC	PHYSICIANS & SURGEONS PHARMACY	900 N PORTER, SUITE 101	NORMAN	OK	73071	10/01/2014	03/01/2017
CH063620	PREMIER PHARMACY SERVICES	410 CLOVERLEAF DR		BALDWIN PARK	CA	91706	07/01/2022
CH063620	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	07/01/2022
CH063620	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	07/01/2022
CH063620	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	07/01/2022
CH063620	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	07/01/2022
CH063620	VARIETY CARE PHARMACY #500	VARIETY CARE, INC.	500 SW 44TH ST	OKLAHOMA CITY	OK	73109	10/01/2014
CH063620	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2018
CH06362B	WAL-MART PHARMACY 10-0162	1201 W. PETREE ROAD		ANADARKO	OK	73005	07/01/2020
CH06362H	WAL-MART PHARMACY 10-0162	1201 W. PETREE ROAD		ANADARKO	OK	73005	01/01/2021
CH063620	WAL-MART PHARMACY 10-0544	5401 TINKER DIAGONAL ST.		DEL CITY(MWC)	OK	73115	01/01/2025
CH063620	WAL-MART PHARMACY 10-0622	7800 NORTHWEST EXPRESSWAY		OKLAHOMA CITY	OK	73132	01/01/2025
CH063620	WAL-MART PHARMACY 10-1626	2000 WEST MEMORIAL ROAD		OKLAHOMA CITY	OK	73134	01/01/2020
CH063620	WAL-MART PHARMACY 10-2394	1500 SW 59TH STREET		OKLAHOMA CITY	OK	73119	01/01/2018
CH063620	WAL-MART PHARMACY 10-3615	2217 NORTHWEST 23RD STREET		OKLAHOMA CITY(23RD)	OK	73107	01/01/2025
CH063620	WAL-MART PHARMACY 10-5286	9320 NORTH PENN AVE		THE VILLAGE	OK	73120	01/01/2020
CH063620	WAL-MART PHARMACY 10-5314	4420 S. WESTERN AVE		OKLAHOMA CITY	OK	73109-3414	01/01/2018
CH063620	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2018
CH063620	WALGREEN CO.	DBA: WALGREENS # 02543	2345 N CLASSEN BLVD	OKLAHOMA CITY	OK	73106-5804	07/01/2016
CH063620	WALGREEN CO.	DBA: WALGREENS # 03642	4500 SOUTH SHIELDS BLVD	OKLAHOMA CITY	OK	73129	07/01/2016	01/10/2025
CH063620	WALGREEN CO.	DBA: WALGREENS # 03643	9011 SOUTH PENNSYLVANIA AVE	OKLAHOMA CITY	OK	73159	07/01/2016
CH063620	WALGREEN CO.	DBA: WALGREENS # 03647	100 12TH AVENUE NE	NORMAN	OK	73071	07/01/2016
CH063620	WALGREEN CO.	DBA: WALGREENS # 04011	2835 SW 29TH STREET	OKLAHOMA CITY	OK	73119	07/01/2016
CH063620	WALGREEN CO.	DBA: WALGREENS # 04098	5120 N MAY AVENUE	OKLAHOMA CITY	OK	73112	07/01/2016
CH063620	WALGREEN CO.	DBA: WALGREENS # 04603	6000 S. PENNSYLVANIA	OKLAHOMA CITY	OK	73159	07/01/2016	01/10/2025
CH063620	WALGREEN CO.	DBA: WALGREENS # 06477	615 W MAIN STREET	NORMAN	OK	73069-7062	07/01/2016
CH063620	WALGREEN CO.	DBA: WALGREENS # 06834	4400 NW 23RD STREET	OKLAHOMA CITY	OK	73107-2644	07/01/2016
CH063620	WALGREEN CO.	DBA: WALGREENS # 07816	1019 E MAIN STREET	WEATHERFORD	OK	73096	07/01/2016
CH063620	WALGREEN CO.	DBA: WALGREENS #10957	3232 TRI CITY DR.	NEWCASTLE	OK	73065	07/01/2016
CH063620	WALGREEN CO.	DBA: WALGREENS #13123	116 N. GREEN AVENUE	PURCELL	OK	73080	07/01/2016	11/25/2024
CH063620	WALGREEN CO.	DBA: KEN'S DISCOUNT, A WALGREENS PHARMAC	808 N PORTER AVE	NORMAN	OK	73071	07/01/2016	07/13/2022
CH063620	WALGREEN CO.	DBA: WALGREENS # 03786	1201 NW 12TH STREET	MOORE	OK	73170	01/01/2022
CH063620	WALGREEN CO.	DBA: WALGREENS # 07222	112 E STATE HWY 152	MUSTANG	OK	73064-4402	01/01/2022
CH063620	WALGREEN CO.	DBA: WALGREENS # 04066	1099 GARTH BROOKS BLVD.	YUKON	OK	73099	01/01/2022
CH063620	WALGREEN CO.	DBA: WALGREENS # 09582	8917 NE 23RD ST	OKLAHOMA CITY	OK	73141	01/01/2022
CH063620	WALGREEN CO.	DBA: WALGREENS # 06436	1400 EAST SECOND ST	EDMOND	OK	73034-5321	01/01/2022
CH063620	WALGREEN CO.	DBA: WALGREENS # 03748	4300 SOUTHEAST 29TH ST	DEL CITY	OK	73115	04/01/2024
CH063620	WALGREEN CO.	DBA: WALGREENS # 03718	6350 N. MACARTHUR	WARR ACRES	OK	73122	04/01/2024
CH063620	WALGREEN CO.	DBA: WALGREENS # 04784	2100 W BRITTON RD	OKLAHOMA CITY	OK	73120	01/01/2025
CH063620	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16515	519 NW 23RD ST STE 109	OKLAHOMA CITY	OK	73103	01/01/2025
CH063620	WALGREEN CO.	DBA: WALGREENS # 01423	2316 N ROCKWELL AVE	BETHANY	OK	73008	01/01/2025
CH063620	WALGREEN CO.	DBA: WALGREENS # 03645	101 NORTH MIDWEST BLVD.	MIDWEST CITY	OK	73110	01/01/2025
CH063620	WALGREEN CO.	DBA: WALGREENS # 04895	2400 N MAY AVE	OKLAHOMA CITY	OK	73107	04/01/2025
CH063620	WALGREEN CO.	DBA: WALGREENS # 05967	1601 S AIR DEPOT BLVD	MIDWEST CITY	OK	73110	04/01/2025
CH063620	WALGREEN CO.	DBA: WALGREENS #10916	1621 S. DIVISION ST.	GUTHRIE	OK	73044	07/01/2025
CH063620	WALGREEN CO.	DBA: WALGREENS # 09223	9950 SE 15TH STREET	MIDWEST CITY	OK	73130	07/01/2025
CH063620	WALGREEN CO.	DBA: WALGREENS # 05738	1229 N EASTERN AVE	MOORE	OK	73160	07/01/2025
CH063620	Walgreens #21373	Walgreens Central Fill #21373	4100 Dale Earnhardt Way STE 200	Northlake	TX	76262	07/01/2024
CH063620	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2016
CH063620	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	07/01/2016	11/01/2021
CH063620	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2016
CH063620	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2016

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		CARMICHAEL, LOU CEO Variety Care, Inc. 4056361675	4/17/2025 7:49 AM
Details	340B ID	Update	New Registration		CH06362AF	4/17/2025 7:49 AM
Dates	Participating Approval Date	Update	New Registration		4/17/2025 7:49:51 AM	4/17/2025 7:49 AM
Details	State	Update	New Registration	Pending	Approved	4/17/2025 7:49 AM
Dates	Signed By Date	Update	New Registration		4/15/2025 2:05:43 PM	4/17/2025 7:49 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/17/2025 7:49 AM
Addresses	Main Address	Insert	New Registration		2000 E 15th St, Suite 400A Edmond, OK 73013-6673	4/15/2025 1:22 PM
Contacts	Authorizing Official	Insert	New Registration		CARMICHAEL, LOU CEO Variety Care, Inc. 4056361675	4/15/2025 1:22 PM
Contacts	Primary Contact	Insert	New Registration		Phan, Mickey Director of Pharmacy Variety Care 4056326688-10150	4/15/2025 1:22 PM
Details	Assistance Received From Date	Insert	New Registration			4/15/2025 1:22 PM
Details	Assistance Received To Date	Insert	New Registration			4/15/2025 1:22 PM
Details	Last Recertification Date	Insert	New Registration			4/15/2025 1:22 PM
Details	Grant Number	Insert	New Registration		H80CS00543	4/15/2025 1:22 PM
Details	340B ID	Insert	New Registration			4/15/2025 1:22 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/15/2025 1:22 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/15/2025 1:22 PM
Details	Medicare Provider Number	Insert	New Registration			4/15/2025 1:22 PM
Details	Entity Name	Insert	New Registration		VARIETY CARE, INC.	4/15/2025 1:22 PM
Details	NOFO Number	Insert	New Registration			4/15/2025 1:22 PM
Details	Program Code	Insert	New Registration		CH	4/15/2025 1:22 PM
Details	Entity Subname	Insert	New Registration		Variety Care Turtle Creek-Edmond	4/15/2025 1:22 PM
Dates	Participating Approval Date	Insert	New Registration			4/15/2025 1:22 PM
Details	State	Insert	New Registration		Pending	4/15/2025 1:22 PM
Dates	Registration Date	Insert	New Registration		4/15/2025 1:22:13 PM	4/15/2025 1:22 PM
Dates	Signed By Date	Insert	New Registration			4/15/2025 1:22 PM
Dates	Start Date	Insert	New Registration			4/15/2025 1:22 PM
Terminations	Termination Comments	Insert	New Registration			4/15/2025 1:22 PM
Terminations	Termination Date	Insert	New Registration			4/15/2025 1:22 PM
Terminations	Termination Effective Date	Insert	New Registration			4/15/2025 1:22 PM
Terminations	Termination Reason	Insert	New Registration			4/15/2025 1:22 PM

340B Drug Pricing Program Database