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CH06362L OKLAHOMA COMMUNITY HEALTH SERVICES, INC. (Terminated)
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Main Details
Name
OKLAHOMA COMMUNITY HEALTH SERVICES, INC.
Subdivision Name
Variety Care - Thomas
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011973
340B ID
CH06362L
Grant Number
H80CS00543
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/28/2014
Last Recertification Date
2/12/2018
Termination Date
Termination Reason
4/1/2019
Site closure
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
100 S 2nd St
Thomas, OK 73669-8201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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