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OKLAHOMA CVS PHARMACY, L.L.C.
CH063620 Variety Care
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Covered Entity Details
Entity Name
Variety Care
Subdivision Name
Variety Care - Straka Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH063620
Entity Address
1025 Straka Ter
Oklahoma City, OK 73139-2544
Grant Number
H80CS00543
Participating Start Date
10/1/2000
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OKLAHOMA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06225
1520 S. BRYANT AVE.
EDMOND, OK 73013
Pharmacy Comments
Contract Details
Approval Date
4/4/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LOU CARMICHAEL, CEO
(405) 636-1675
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/4/2025
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