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WALGREEN CO.
CH0627800 GREAT SALT PLAINS HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
GREAT SALT PLAINS HEALTH CENTER, INC.
Subdivision Name
Great Salt Plains Health Center
Type
HRSA-Funded Health Center
340B ID
CH0627800
Entity Address
405 S. Oklahoma Ave
Cherokee, OK 73728-2545
Grant Number
H80CS08744
Participating Start Date
4/1/2008
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16556
1611 E. 15TH ST.
TULSA, OK 74120
Pharmacy Comments
Contract Details
Approval Date
7/1/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TIM STARKEY, CEO/EXECUTIVE DIRECTOR
(580) 596-2800
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/1/2024
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