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WAL-MART PHARMACY 10-0031
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
WAL-MART PHARMACY 10-0031
Pharmacy Address
3108 N. BROADWAY
POTEAU, OK 74953
Pharmacy Comments
Contract Details
Approval Date
4/11/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TERESA HUGGINS, CEO
(918) 967-4828
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
4/11/2017
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