Contract Pharmacy Details

ASPCARES
STD39216 My Brother's Keeper, Inc.

Covered Entity Details

Entity Name

My Brother's Keeper, Inc.

Subdivision Name

Open Arms Healthcare Center

Type

Sexually Transmitted Diseases

340B ID

STD39216

Entity Address

805 E. River Place
Jackson, MS 39206

Grant Number

NU65PS923762

Participating Start Date

4/1/2014

Last Recertification Date

5/28/2024

Pharmacy Details

Pharmacy Name

ASPCARES

Pharmacy Address

AMERICAN SPECIALTY PHARMACY, INC.
3405 NW EXPRESSWAY
OKLAHOMA CITY, OK 73112

Pharmacy Comments

Contract Details

Approval Date

4/15/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

June Gipson, CEO
(769) 216-2455

Contract Pharmacy Representative

Elite Analytics Group, Inc
Rex Green, CEO
(469) 899-2293

Signed By Date

4/15/2019

340B Drug Pricing Program Database