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OU PHARMACISTS CARE CENTER
HV741031 UNIVERSITY OF OKLAHOMA
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Covered Entity Details
Entity Name
UNIVERSITY OF OKLAHOMA
Subdivision Name
HEALTH SCIENCES CENTER
Type
Ryan White Part C
340B ID
HV741031
Entity Address
INFECTIOUS DISEASES INSTITUTE
711 STANTON L YOUNG BLVD. STE 430
OKLAHOMA CITY, OK 73104
Grant Number
H76HA00185
Participating Start Date
10/1/2002
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
OU PHARMACISTS CARE CENTER
Pharmacy Address
825 NE 10TH ST STE 2A
OKLAHOMA CITY, OK 73104-5417
Pharmacy Comments
Contract Details
Approval Date
5/1/2004
Contract Begin Date
5/1/2004
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
OU Pharmacist Care Center
Bryan Ticer, Pharmacist Manager
(405) 271-6446 Ext: 46321
Signed By Date
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