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REVAN RX
STD73111 Guiding Right, Inc.
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Covered Entity Details
Entity Name
Guiding Right, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD73111
Entity Address
1420 NE 23rd Street
Oklahoma City, OK 73111-3004
Grant Number
NU62PS924721
Participating Start Date
1/1/2018
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
REVAN RX
Pharmacy Address
REVAN INC
5601 NW 72ND ST STE 142
WARR ACRES, OK 73132-5923
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/26/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Theodore H Noel, Chief Executive Officer
(405) 733-0771 Ext: 320
Contract Pharmacy Representative
Revan Health
Justin Evans, CEO
(405) 896-7975
Signed By Date
4/15/2020
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