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SAINT FRANCIS WARREN CLINIC TOWER PHARMA
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
SAINT FRANCIS WARREN CLINIC TOWER PHARMA
Pharmacy Address
SAINT FRANCIS PHARMACY SERVICES, INC
6600 S YALE AVE STE 110
TULSA, OK 74136
Pharmacy Comments
Contract Details
Approval Date
2/22/2017
Contract Begin Date
3/3/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/1/2025
Ownership change
Contacts
Covered Entity Signing Official
Eric Schick, Senior Vice President - Chief Financial Officer
(918) 494-8430
Contract Pharmacy Representative
Saint Francis Pharmacy Services
Jay Tipps, Director
(918) 502-7350
Signed By Date
2/22/2017
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