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RX SHOPPE INC
CH061950AG St. Francis House NWA, Inc.
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Covered Entity Details
Entity Name
St. Francis House NWA, Inc.
Subdivision Name
Family Medical Center
Type
HRSA-Funded Health Center
340B ID
CH061950AG
Entity Address
1121 Neo Loop
Grove, OK 74344
Grant Number
H80CS04290
Participating Start Date
7/1/2024
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RX SHOPPE INC
Pharmacy Address
901 S MAIN ST
GROVE, OK 74344
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Semingson II, Chief Executive Officer
(479) 751-7417 Ext: 6070
Contract Pharmacy Representative
Rx Shoppe
Teresa Butler, Owner
(918) 786-1092
Signed By Date
7/15/2024
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