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OKLAHOMA CVS PHARMACY, L.L.C.
FP730132 Planned Parenthood Great Plains
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Covered Entity Details
Entity Name
Planned Parenthood Great Plains
Subdivision Name
South Boulevard Health Center
Type
Family Planning (Title X only)
340B ID
FP730132
Entity Address
1601 South Blvd.
Edmond, OK 73013
Grant Number
FPHPA006561
Participating Start Date
1/1/2024
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
OKLAHOMA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06234
3200 S. SANTA FE AVE.
EDMOND, OK 73013
Pharmacy Comments
Contract Details
Approval Date
1/10/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/10/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Emily Wales, President & CEO
(913) 345-4613
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/10/2024
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