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CHECOTAH PHARMACY
CH0619510 STIGLER HEALTH AND WELLNESS CENTER, INC
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Covered Entity Details
Entity Name
STIGLER HEALTH AND WELLNESS CENTER, INC
Subdivision Name
HWC - Stigler
Type
HRSA-Funded Health Center
340B ID
CH0619510
Entity Address
1505 E. MAIN STREET
STIGLER, OK 74462
Grant Number
H80CS04286
Participating Start Date
4/1/2005
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
CHECOTAH PHARMACY
Pharmacy Address
1002 W GENTRY, STE B
CHECOTAH, OK 74426
Pharmacy Comments
10/24/2012 DEA address update (was 1000 West Gentry Street)
Contract Details
Approval Date
8/22/2011
Contract Begin Date
8/22/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/16/2020
Ownership change
Contacts
Covered Entity Signing Official
TERESA HUGGINS, CEO
(918) 967-4828
Contract Pharmacy Representative
Stigler Health and Wellness Center
Efton Bryon Glover, pharmacy director
(918) 967-3368
Signed By Date
7/22/2011
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