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LOVELL'S PHARMACY
CH06362H Variety Care, Inc.
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Covered Entity Details
Entity Name
Variety Care, Inc.
Subdivision Name
Variety Care Pediatric Center on North Portland
Type
HRSA-Funded Health Center
340B ID
CH06362H
Entity Address
5320 N. Portland Ave.
Oklahoma City, OK 73112-2098
Grant Number
H80CS00543
Participating Start Date
4/1/2011
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
LOVELL'S PHARMACY
Pharmacy Address
602 W CENTRAL BLVD
ANADARKO, OK 73005-3228
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LOU CARMICHAEL, CEO
(405) 636-1675
Contract Pharmacy Representative
Lovell's Pharmacy
Clendon Lovell, Owner
(405) 247-3348
Signed By Date
10/15/2020
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