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24/7 CCMH COMMUNITY PHARMACY
CHC08779-00 COMANCHE COUNTY HOSPITAL AUTHORITY (TRUST)
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Covered Entity Details
Entity Name
COMANCHE COUNTY HOSPITAL AUTHORITY (TRUST)
Subdivision Name
Comanche County Hospital Authority DBA Lawton Community Health Center
Type
HRSA-Funded Health Center
340B ID
CHC08779-00
Entity Address
5404 Southwest Lee Boulevard
Lawton, OK 73505
Grant Number
H80CS08779
Participating Start Date
7/1/2009
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
24/7 CCMH COMMUNITY PHARMACY
Pharmacy Address
COMANCHE COUNTY HOSPITAL AUTHORITY
3401 W GORE BLVD
LAWTON, OK 73505
Pharmacy Comments
Contract Details
Approval Date
10/4/2023
Contract Begin Date
10/6/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brent Smith, CEO
(580) 585-5852
Contract Pharmacy Representative
Comanche County Memorial Hospital
Cheryl Hale, Director of Pharmacy
(580) 585-5436 Ext: 3277
Signed By Date
10/4/2023
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