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MED-X CORPORATION
DSH370091 Saint Francis Hospital
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Covered Entity Details
Entity Name
Saint Francis Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH370091
Entity Address
6161 South Yale Avenue
Tulsa, OK 74136
Medicare Provider Number
370091
Participating Start Date
4/1/2012
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
MED-X CORPORATION
Pharmacy Address
DBA: WALGREENS #15782
1714 UTICA SQUARE
TULSA, OK 74114
Pharmacy Comments
Contract Details
Approval Date
7/14/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eric Schick, Senior Vice President - Chief Financial Officer
(918) 494-8430
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/14/2015
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