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1893 PHARMACY
HV741031 UNIVERSITY OF OKLAHOMA
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Covered Entity Details
Entity Name
UNIVERSITY OF OKLAHOMA
Subdivision Name
HEALTH SCIENCES CENTER
Type
Ryan White Part C
340B ID
HV741031
Entity Address
INFECTIOUS DISEASES INSTITUTE
711 STANTON L YOUNG BLVD. STE 430
OKLAHOMA CITY, OK 73104
Grant Number
H76HA00185
Participating Start Date
10/1/2002
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
1893 PHARMACY
Pharmacy Address
BOARD OF REGENTS OF THE UNIVERSITY OF OK
901 N STONEWALL AVE STE 1200
OKLAHOMA CITY, OK 73117
Pharmacy Comments
Contract Details
Approval Date
10/10/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ashley Krukowski, Associate Vice President for Research Administration
(405) 271-2090
Contract Pharmacy Representative
OUHSC
Jay Kinnard, Pharmacist in Charge
(405) 271-8931 Ext: 33896
Signed By Date
10/10/2022
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