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SAINT FRANCIS OUTPATIENT PHARMACY
RRC370025-00 Saint Francis Hospital Muskogee
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Covered Entity Details
Entity Name
Saint Francis Hospital Muskogee
Subdivision Name
Type
Rural Referral Center
340B ID
RRC370025-00
Entity Address
300 ROCKEFELLER DRIVE
MUSKOGEE, OK 74401
Medicare Provider Number
370025
Participating Start Date
7/1/2018
Last Recertification Date
9/12/2022
Entity Termination Date
1/1/2023
Pharmacy Details
Pharmacy Name
SAINT FRANCIS OUTPATIENT PHARMACY
Pharmacy Address
SAINT FRANCIS HOSPITAL, INC
6161 S YALE AVE
B LEVEL BLUE NORTH
TULSA, OK 74136
Pharmacy Comments
Contract Details
Approval Date
7/8/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/12/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Eric Schick, Senior Vice President - Chief Financial Officer
(918) 494-8430
Contract Pharmacy Representative
Saint Francis Pharmacy Services
Jay Tipps, Director
(918) 502-7350
Signed By Date
7/8/2020
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