Contract Pharmacy Details

WARNER FAMILY PHARMACY
CAH371335-00 Haskell Regional Hospital, Inc

Covered Entity Details

Entity Name

Haskell Regional Hospital, Inc

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH371335-00

Entity Address

401 NW H STREET
STIGLER, OK 74462

Medicare Provider Number

371335

Participating Start Date

4/1/2021

Last Recertification Date

8/22/2024

Pharmacy Details

Pharmacy Name

WARNER FAMILY PHARMACY

Pharmacy Address

SEQUOYAH COUNTY DRUG CO LLC
806 N CAMPBELL AVE STE B
WARNER, OK 74469

Pharmacy Comments

Contract Details

Approval Date

4/9/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Naji Al-Saeed, Administrator
(507) 272-2769

Contract Pharmacy Representative

Warner Family Pharmacy
Andrea J Self, Owner
(918) 463-5444

Signed By Date

4/9/2025

340B Drug Pricing Program Database