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GLN OF CHECOTAH
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
GLN OF CHECOTAH
Pharmacy Address
D/B/A NICHOLS PHARMACY
207 NORTH BROADWAY
P.O. BOX 426
CHECOTAH, OK 74426
Pharmacy Comments
Contract Details
Approval Date
4/10/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/3/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
TERESA HUGGINS, CEO
(918) 967-4828
Contract Pharmacy Representative
Bob Chapman, Pharmacy Supervisor
(918) 473-2304
Signed By Date
4/10/2013
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