340B Drug Pricing Program Database


CHC08779-03 COMANCHE COUNTY HOSPITAL AUTHORITY (Terminated) - information as of 5/8/2025 10:24:22 PM

Main Details
COMANCHE COUNTY HOSPITAL AUTHORITY
Jim Taliaferro Mental Health Center
HRSA-Funded Health Center
BPS-H80-017049
CHC08779-03
H80CS08779


Additional Details
Terminated
1/15/2016
4/1/2016
2/10/2016
2/1/2019

4/1/2020
Site closure

Contacts

Lawton Community Health Center
Brent Smith, CEO
(580) 585-5852

Lawton community health center
Sean McAvoy, Executive Director
(580) 280-4413

Addresses

602 SW 38th Street
Lawton, OK 73505-6912

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Same as Street Address
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CHC08779-00ActiveBPS-H80-013747COMANCHE COUNTY HOSPITAL AUTHORITY (TRUST)Comanche County Hospital Authority DBA Lawton Community Health Center5404 Southwest Lee Boulevard LawtonOK
CHC08779-01ActiveBPS-H80-015473COMANCHE COUNTY HOSPITAL AUTHORITYComanche Community Health Center513 HILLERY RD COMANCHEOK
CHC08779-02ActiveBPS-H80-015475COMANCHE COUNTY HOSPITAL AUTHORITYMarlow Community Health Center1324 S BROADWAY ST MARLOWOK
CHC08779-03TerminatedBPS-H80-017049COMANCHE COUNTY HOSPITAL AUTHORITYJim Taliaferro Mental Health Center602 SW 38th Street LawtonOK
CHC08779-04ActiveBPS-H80-017664COMANCHE COUNTY HOSPITAL AUTHORITYElgin Community Health Center7936 US Highway 277 ElginOK
CHC08779-05ActiveBPS-H80-019406Comanche County Hospital AuthorityLCHC Eastside1102 SE 36th Street LawtonOK
CHC08779-06ActiveBPS-H80-008861Comanche County Hospital AuthorityLCHC Center for Health3811 W. Gore Blvd. STE 6 LawtonOK
CHC08779-07ActiveBPS-H80-019110Comanche County Hospital AuthorityLCHC Primary Health Care Center at Comanche County Memorial Hospital110 NW 31st Street Suite 201 LawtonOK
CHC08779-08ActiveBPS-H80-020807Comanche County Hospital AuthorityComanche School Health Center1030 Ash Ave ES 165 ComancheOK
CHC08779-09ActiveBPS-H80-022122Comanche County Hospital AuthorityLCHC Family Care Clinic3201 West Gore Boulevard, Suite 203 LawtonOK
CHC08779-10ActiveBPS-H80-027782Comanche County Hospital AuthorityLCHC Cache512 W C Ave CacheOK
CHC08779-11ActiveBPS-H80-027843Comanche County Hospital AuthorityLCHC Midtown1202 NW Arlington Ave LawtonOK
CHC08779-12ActiveBPS-H80-030234Comanche County Hospital AuthorityLCHC Center for Health Suite 103811 W Gore Blvd Ste 10 LawtonOK
CHC08779-13ActiveBPS-H80-030817Comanche County Hospital AuthorityLCHC Apache1102 S Coblake St ApacheOK
CHC08779-14ActiveBPS-H80-031275Comanche County Hospital AuthorityLCHC Burns Flat825 Sooner Drive Burns FlatOK
CHC08779-15ActiveBPS-H80-031212Comanche County Hospital AuthorityLCHC Memorial Medical Clinic3201 W Gore Blvd Ste 304 LawtonOK
CHC08779-16ActiveBPS-H80-031211Comanche County Hospital AuthorityLCHC Family Health Clinic3201 W Gore Blvd Ste 301 LawtonOK
CHC08779-17ActiveBPS-H80-032281Comanche County Hospital AuthorityLCHC Medicine Park19055 State Highway 49 Medicine ParkOK
CHC08779-18ActiveBPS-H80-032429Comanche County Hospital AuthorityLCHC Great Plains Pediatrics3201 W Gore Blvd Ste 100 LawtonOK
CHC08779-19ActiveBPS-H80-034728Comanche County Hospital AuthorityLCHC Lawton Pediatrics2701 SW Cornell Ave LawtonOK
CHC08779-20ActiveBPS-H80-031825Comanche County Hospital AuthorityLCHC Family Dentistry6740 NW Cache Rd LawtonOK
CHC08779-21ActiveBPS-H80-033825COMANCHE COUNTY HOSPITAL AUTHORITY (TRUSLCHC Southcare Clinic512 SW Lee Blvd LawtonOK
CHC08779-22ActiveBPS-H80-037157COMANCHE COUNTY HOSPITAL AUTHORITY (TRUSLCHC Family Continuity Clinic2609 SW Lee Blvd LawtonOK
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CHC08779-0024/7 CCMH COMMUNITY PHARMACYCOMANCHE COUNTY HOSPITAL AUTHORITY 3401 W GORE BLVD
LAWTONOK7350510/06/2023  
CHC08779-00ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201007/01/2025  
CHC08779-00ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884907/01/2025  
CHC08779-00ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349207/01/2025  
CHC08779-00AHSSHCEXPEDIEN RX PHARMACY 5050 WESLEY RD STE 120
APOPKAFL3271210/01/2017  
CHC08779-00AMAZON PHARMACY #0014500 S PLEASANT VALLEY RD STE 201
AUSTINTX78744-291107/01/2018  
CHC08779-00APACHE DRUG118 E EVANS AVE P.O. BOX 315
APACHEOK73006-919004/01/2020  
CHC08779-00AZ PHARMACY, LLCDBA AMAZON PHARMACY #002 3809 E WATKINS ST
PHOENIXAZ8503404/01/2019  
CHC08779-00COMANCHE COUNTY MEMORIAL HOSPPHARMACY DEPARTMENT 3401 W GORE BLVD
LAWTONOK7350504/01/2021 11/13/2023
CHC08779-00CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2021  
CHC08779-00CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2021  
CHC08779-00CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502804/01/2024  
CHC08779-00DELIVERCARERX PHARMACY LLCDELIVERCARERX PHARMACY LLC 1471 E BUSINESS CENTER DR
STE 200 		MT PROSPECTIL6005610/01/2017  
CHC08779-00EASTSIDE PHARMACY3612 SE LEE BLVD
LAWTONOK7350104/01/2020 10/04/2023
CHC08779-00EASTSIDE PHARMACY3612 SE LEE BLVD
LAWTONOK7350101/01/2024  
CHC08779-00ELGIN PHARMACY, LLC12889 COMMERCE ST
ELGINOK7353807/01/2018  
CHC08779-00ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111207/01/2025  
CHC08779-00EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313407/01/2025  
CHC08779-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607507/01/2025  
CHC08779-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801607/01/2025  
CHC08779-00GREAT PLAINS PHARMACYGREAT PLAINS PHARMACY 3201 W GORE BLVD STE A
LAWTONOK7350510/01/2014  
CHC08779-00KEN'S RX802 W GORE BLVD
LAWTONOK73501-371904/01/2020 10/04/2023
CHC08779-00LAWTON HERITAGE COMPOUNDING PHARMACY12 NW SHERIDAN RD
LAWTONOK7350504/01/2020 04/30/2022
CHC08779-00M.N. PHARMACY LLCDBA AMAZON PHARMACY #003 6701 NW 7TH ST., STE. #199
MIAMIFL3312607/01/2018  
CHC08779-00MAXOR PHARMACIES901 SW GOODYEAR BLVD
LAWTONOK7350507/01/2024  
CHC08779-00OKLAHOMA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 10520 2107 NW CACHE ROAD
LAWTONOK7350501/01/2020  
CHC08779-00OKLAHOMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06128 1016 SW LEE BLVD
LAWTONOK7350101/01/2020  
CHC08779-00OKLAHOMA CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 10274 1520 WEST ELK AVE.
DUNCANOK7353304/01/2024  
CHC08779-00OKLAHOMA CVS PHARMACY, L.L.C.CVS PHARMACY # 17612 2030 NW 82ND STREET
LAWTONOK7350504/01/2024  
CHC08779-00OPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520410/01/2024  
CHC08779-00OPTUM PHARMACY 704, INC.5627 UNIVERSITY HTS STE 108
SAN ANTONIOTX7824910/01/2024  
CHC08779-00OPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983810/01/2024  
CHC08779-00PILLPACK LLCDBA PILLPACK BY AMAZON PHARMACY 250 COMMERCIAL ST STE 2012
MANCHESTERNH0310107/01/2018  
CHC08779-00SHERIDAN EXPRESS PHARMACY205 SW SHERIDAN RD
LAWTONOK7350504/01/2020  
CHC08779-00WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2018  
CHC08779-00WAL-MART PHARMACY 10-02691002 N.W. SHERIDAN ROAD
LAWTONOK7350510/01/2014  
CHC08779-00WAL-MART PHARMACY 10-50716301 NW QUANNAH PARKER TRWAY
LAWTONOK7350510/01/2014  
CHC08779-00WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2018  
CHC08779-00WALGREEN CO.DBA: WALGREENS # 04703 701 NW SHERIDAN
LAWTONOK7350510/01/2014  
CHC08779-00WALGREEN CO.DBA: WALGREENS # 06199 6701 NW CACHE ROAD
LAWTONOK7350510/01/2014  
CHC08779-00WALGREEN CO.DBA: WALGREENS #12833 1107 SW LEE BLVD.
LAWTONOK73501-560510/01/2014 08/11/2016
CHC08779-00Walgreens #21373Walgreens Central Fill #21373 4100 Dale Earnhardt Way
STE 200 		NorthlakeTX7626207/01/2024  
CHC08779-00WALGREENS MAIL SERVICE, INC.  8337 S PARK CIRCLE
ORLANDOFL32819-904910/01/2014 06/24/2015
CHC08779-00WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528410/01/2014 06/24/2015
CHC08779-00WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/01/2022  
CHC08779-00WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275601/01/2024  
CHC08779-00Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsStateUpdate To Be TerminatedTerminated4/1/2020 12:05 AM
DatesLast Date That 340B Drugs PurchasedUpdateRecertification 2/24/2020 12:00:00 AM2/3/2020 6:29 AM
DetailsStateUpdateRecertificationActiveTo Be Terminated2/3/2020 6:29 AM
TerminationsTermination CommentsUpdateRecertification Located within a state owned building and contract was canceled by the State2/3/2020 6:29 AM
TerminationsTermination DateUpdateRecertification 4/1/2020 12:00:00 AM2/3/2020 6:29 AM
TerminationsTermination Effective DateUpdateRecertification 3/1/2020 12:00:00 AM2/3/2020 6:29 AM
TerminationsTermination ReasonUpdateRecertification Site closure2/3/2020 6:29 AM
Medicaid BillingMedicaid: NumberDeleteChange Request200568270A (OK) 10/11/2019 10:06 AM
Medicaid BillingNPI: NumberDeleteChange Request1871935247 ( ) 10/11/2019 10:06 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/4/2019 3:51 PM
Medicaid BillingMedicaid: NumberInsertChange Request 200568270A3/4/2019 3:51 PM
Medicaid BillingMedicaid: StateInsertChange Request OK3/4/2019 3:51 PM
Medicaid BillingNPI: NumberInsertChange Request 18719352473/4/2019 3:51 PM
DetailsLast Recertification DateUpdateRecertification2/16/2018 9:43:50 AM2/1/2019 12:58:12 PM2/1/2019 12:58 PM
ContactsPrimary ContactUpdateRecertificationMcAvoy, Sean Executive Director 5802804413McAvoy, Sean Executive Director Lawton community health center 58028044132/16/2018 9:43 AM
DetailsLast Recertification DateUpdateRecertification1/30/2017 12:00:00 AM2/16/2018 9:43:50 AM2/16/2018 9:43 AM
DetailsIs Authorizing Official EHB DataUpdateRecertificationFalse 2/16/2018 9:43 AM
ContactsAuthorizing OfficialUpdateAO Change RequestSmith, Brent CHIEF FINANCIAL OFFICER 5803558620-5522Smith, Brent CEO Lawton Community Health Center 58058558521/31/2018 10:07 AM
ContactsAuthorizing OfficialInsert  Smith, Brent CHIEF FINANCIAL OFFICER 5803558620-55228/10/2017 3:28 PM
ContactsSigned ByInsert  Smith, Brent CHIEF FINANCIAL OFFICER 5803558620-55228/10/2017 3:28 PM
AddressesMain AddressInsert   602 SW 38th Street Lawton, OK 73505-69121/30/2017 4:13 PM
ContactsPrimary ContactInsert  McAvoy, Sean Executive Director 58028044131/30/2017 4:13 PM
DetailsLast Recertification DateUpdate  1/30/2017 12:00:00 AM1/30/2017 4:13 PM
DatesParticipating Approval DateUpdate  2/10/2016 12:00:00 AM2/10/2016 3:28 PM
DetailsStateUpdate PendingActive2/10/2016 3:28 PM
DatesStart DateUpdate  4/1/2016 12:00:00 AM2/10/2016 3:28 PM
Details340B IDUpdate ONLINE_REG_58375CHC08779-031/19/2016 1:38 PM
Details340B IDUpdate ONLINE_REGONLINE_REG_583751/15/2016 4:00 PM
DetailsLast Recertification DateInsert   1/15/2016 4:00 PM
DetailsGrant NumberInsert  H80CS087791/15/2016 4:00 PM
Details340B IDInsert  ONLINE_REG1/15/2016 4:00 PM
DetailsIs Authorizing Official EHB DataInsert  False1/15/2016 4:00 PM
DatesLast Date That 340B Drugs PurchasedInsert   1/15/2016 4:00 PM
DetailsMedicare Provider NumberInsert   1/15/2016 4:00 PM
DetailsEntity NameInsert  COMANCHE COUNTY HOSPITAL AUTHORITY1/15/2016 4:00 PM
DetailsProgram CodeInsert  CH1/15/2016 4:00 PM
DetailsEntity SubnameInsert  Jim Taliaferro Mental Health Center1/15/2016 4:00 PM
DatesParticipating Approval DateInsert   1/15/2016 4:00 PM
DetailsStateInsert  Pending1/15/2016 4:00 PM
DatesRegistration DateInsert  1/15/2016 12:00:00 AM1/15/2016 4:00 PM
DatesSigned By DateInsert  1/15/2016 12:00:00 AM1/15/2016 4:00 PM
DatesStart DateInsert   1/15/2016 4:00 PM
TerminationsTermination CommentsInsert   1/15/2016 4:00 PM
TerminationsTermination DateInsert   1/15/2016 4:00 PM
TerminationsTermination Effective DateInsert   1/15/2016 4:00 PM
TerminationsTermination ReasonInsert   1/15/2016 4:00 PM