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ASPCARES
STD731121 Community Nursing Center of Oklahoma City, LLC dba Diversity Family Health
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Covered Entity Details
Entity Name
Community Nursing Center of Oklahoma City, LLC dba Diversity Family Health
Subdivision Name
The Diversity Center of Oklahoma Site
Type
Sexually Transmitted Diseases
340B ID
STD731121
Entity Address
2242 NW 39th Street
Oklahoma City, OK 73112
Grant Number
NH25PS005143
Participating Start Date
4/1/2020
Last Recertification Date
Entity Termination Date
7/1/2020
Pharmacy Details
Pharmacy Name
ASPCARES
Pharmacy Address
2655 NW 20TH ST
MIAMI, FL 33142-7105
Pharmacy Comments
Contract Details
Approval Date
3/3/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Russell Ryan Rooms, Director
(405) 848-0026
Contract Pharmacy Representative
Elite Analytics Group, Inc
Rex Green, CEO
(469) 899-2293
Signed By Date
1/7/2020
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