340B Drug Pricing Program Database

Pharmacy Name

OKLAHOMA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 03883
9000 S. MAY AVE.
OKLAHOMA CITY, OK 73159

Pharmacy Comments

Approval Date

2/22/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/19/2016
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

James D. Moore, President
(405) 636-7690

Contract Pharmacy Representative

CVS
Scott Tierney, Senior Director, Payer Relations
(401) 770-2762

Signed By Date

1/14/2013