Contract Pharmacy Details

FIKES PHARMACY
CH063620 Variety Care

Covered Entity Details

Entity Name

Variety Care

Subdivision Name

Variety Care - Straka Family Health Center

Type

HRSA-Funded Health Center

340B ID

CH063620

Entity Address

1025 Straka Ter
Oklahoma City, OK 73139-2544

Grant Number

H80CS00543

Participating Start Date

10/1/2000

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

FIKES PHARMACY

Pharmacy Address

101 EAST 2ND STREET
GRANDFIELD, OK 73546-0159

Pharmacy Comments

Contract Details

Approval Date

3/12/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

LOU CARMICHAEL, CEO
(405) 632-6688 Ext: 233

Contract Pharmacy Representative

Cory Fikes, PIC/Owner
(580) 479-5696

Signed By Date

1/15/2013