340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PRUETT'S FOOD - PHARMACY #9
CAH371319-00 COAL COUNTY
Print
Covered Entity Details
Entity Name
COAL COUNTY
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH371319-00
Entity Address
6 NORTH COVINGTON
COALGATE, OK 74538
Medicare Provider Number
371319
Participating Start Date
4/1/2019
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
PRUETT'S FOOD - PHARMACY #9
Pharmacy Address
PRUETT'S FOOD, INC
203 E HIGHWAY ST
HOLDENVILLE, OK 74848-4075
Pharmacy Comments
Contract Details
Approval Date
4/8/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Billy D Johnson, Chief Executive Officer
(580) 927-2327 Ext: 272
Contract Pharmacy Representative
Pruett's Food Pharmacy
Shannon Pruett, Owner
(580) 933-5700
Signed By Date
4/8/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session