340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
IDABEL EXPRESS PHARMACY
CH061193D KIAMICHI FAMILY MEDICAL CENTER INC
Print
Covered Entity Details
Entity Name
KIAMICHI FAMILY MEDICAL CENTER INC
Subdivision Name
Kiamichi Family Medical Center - Idabel2
Type
HRSA-Funded Health Center
340B ID
CH061193D
Entity Address
2809 NE Lincoln Rd
Idabel, OK 74745
Grant Number
H80CS00267
Participating Start Date
4/1/2023
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
IDABEL EXPRESS PHARMACY
Pharmacy Address
IDABEL EXPRESS PHARMACY, LLC
810 SE WASHINGTON ST
IDABEL, OK 74745-3332
Pharmacy Comments
Contract Details
Approval Date
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Gilbreath, CEO
(580) 286-6688
Contract Pharmacy Representative
Baker Pharmacy
Ryan Jay Ritter, Owner
(580) 298-6223
Signed By Date
10/14/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session