340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-0231
CH063930 CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC.
Print
Covered Entity Details
Entity Name
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC.
Subdivision Name
CENTRAL OKLAHOMA FAMILY MEDICAL CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH063930
Entity Address
527 West 3rd St
Konawa, OK 74849-1415
Grant Number
H80CS00757
Participating Start Date
4/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0231
Pharmacy Address
1419 N COUNTRY CLUB RD
ADA, OK 74820
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brenda Ware, CEO
(580) 925-3286 Ext: 227
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
1/15/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session