Contract Pharmacy Details

WALGREEN CO.
CH0612740 NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.

Covered Entity Details

Entity Name

NORTHEASTERN OKLAHOMA COMMUNITY HEALTH CENTERS, INC.

Subdivision Name

NE OK COMMUNITY HLTH CENTERS

Type

HRSA-Funded Health Center

340B ID

CH0612740

Entity Address

124 E Main St
Hulbert, OK 74441-8902

Grant Number

H80CS00848

Participating Start Date

1/1/2004

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA; COX DRUG, A WALGREENS PHARMACY
1301 E DOWNING ST
TAHLEQUAH, OK 74464

Pharmacy Comments

Contract Details

Approval Date

1/1/2004

Contract Begin Date

1/1/2004

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

340B Drug Pricing Program Database