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CH0614360 FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA (Active)
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Main Details
Name
FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA
Subdivision Name
FAMILY HEALTH CENTER OF SOUTHERN OKLAHOMA
Type
HRSA-Funded Health Center
Site ID
BPS-H80-009310
340B ID
CH0614360
Grant Number
H80CS02454
Additional Details
Current Program Status
Active
Registration Date
7/1/2004
Participating Start Date
7/1/2004
Participating Approval Date
5/19/2004
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Family Health Center of Southern Oklahoma
TINA JAREE DAVIS, CEO
(580) 371-2343 Ext: 322
Primary Contact
Family Health Center of Southern Oklahoma, Inc.
Joe Burns, Pharmacy Director
(580) 371-2343 Ext: 3345
Addresses
Street Address
610 E. 24TH STREET
TISHOMINGO, OK 73460
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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12/13/10 UPDATED PHYS ADD (WAS 1040 SOUTH BYRD, TISHOMINGO, OK)
12/13/2010
April 2025
April 2025
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