Contract Pharmacy Details

OKLAHOMA CVS PHARMACY, L.L.C.
CH06393B CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC.

Subdivision Name

Central Oklahoma Family Medical Center - Ada

Type

HRSA-Funded Health Center

340B ID

CH06393B

Entity Address

1221 Arlington Street
B
Ada, OK 74820-4067

Grant Number

H80CS00757

Participating Start Date

7/1/2016

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

OKLAHOMA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY # 10275
21 SOUTH STRONG BLVD.
MCALESTER, OK 74501

Pharmacy Comments

Contract Details

Approval Date

10/7/2022

Contract Begin Date

1/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/15/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Brenda Ware, CEO
(580) 925-3286 Ext: 227

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/7/2022

340B Drug Pricing Program Database