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REVAN RX
STD73112 Guiding Right, Inc.
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Covered Entity Details
Entity Name
Guiding Right, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD73112
Entity Address
2242 NW 39th Street
Oklahoma City, OK 73112
Grant Number
NU62PS924721
Participating Start Date
1/1/2020
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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