340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HEADS PHARMACY
CAH371335-00 Haskell Regional Hospital, Inc
Print
Covered Entity Details
Entity Name
Haskell Regional Hospital, Inc
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH371335-00
Entity Address
401 NW H STREET
STIGLER, OK 74462
Medicare Provider Number
371335
Participating Start Date
4/1/2021
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
HEADS PHARMACY
Pharmacy Address
501 NW H ST
STIGLER, OK 74462-1627
Pharmacy Comments
Contract Details
Approval Date
2/19/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/6/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Andrea Karessa Randall, Administrator
(918) 967-4682 Ext: 9184480944
Contract Pharmacy Representative
Haskell County Stigler Hosp Authority II
Larry J Godfrey, Chairman
(918) 967-8877
Signed By Date
1/15/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session