340B Drug Pricing Program Database


TB983622 CLALLAM COUNTY HEALTH & HUMAN SERVICES (Active) - information as of 6/12/2025 9:46:25 PM

Main Details
CLALLAM COUNTY HEALTH & HUMAN SERVICES
TB Program
Tuberculosis
TB983622
NU52PS910277


In-Kind products or services (see note below; must have been purchased with section 317 funds)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.
The Washington State TB Program receives 317 funding from the CDC Cooperative Agreement for our TB program. We do not these use federal TB dollars to purchase 340B medications, nor do our LHJs, we use state or local funding. Occasionally we apply for expiring CDC National Stockpile TB medications. If we receive any of these former Stockpile TB medications, they are stored and tracked separately from the 340B TB medications.
1/1/2025 - 12/31/2029


Additional Details
Active
4/1/1996
4/1/1996
11/12/2004
5/5/2025
CDC-RFA-PS25-0003

Contacts

WA State Dept of Health - TB Program
Scott C Hutton, WA State TB Controller/TB Program Manager
(564) 200-3178

Clallam County Health and Human Services
Madison Gallentine, RN, TB program Coordinator
(360) 565-2612

Addresses

111 E. 3rd St.
Port Angeles, WA 98362

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Seattle King County Public Health Downtown Pharmacy
2124 4th Ave
Seattle, WA 98121
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailPUBLIC HEALTHDOWNTOWN CENTRAL PHARMACY 2124 4TH AVE
SEATTLEWA9812101/24/201201/24/2012 06/01/202006/09/2020
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification5/15/2024 7:26:37 AM5/5/2025 4:28:19 PM5/5/2025 4:28 PM
DetailsNature of Support: Support Received From DateUpdateChange Request1/1/2020 12:00:00 AM1/1/2025 12:00:00 AM3/24/2025 5:29 PM
DetailsNature of Support: Support Received To DateUpdateChange Request12/31/2024 12:00:00 AM12/31/2029 12:00:00 AM3/24/2025 5:29 PM
DetailsGrant NumberUpdateGroup Change RequestNU52PS910221NU52PS9102773/18/2025 12:03 PM
DetailsNOFO NumberUpdateGroup Change RequestCDC-RFA-PS20-2001CDC-RFA-PS25-00033/18/2025 12:03 PM
ContactsAuthorizing OfficialUpdateGroup Change RequestPecha, Monica TB Controller Washington Department of Health 2064185544Hutton, Scott C WA State TB Controller/TB Program Manager WA State Dept of Health - TB Program 56420031786/3/2024 4:19 PM
ContactsPrimary ContactUpdateRecertificationLaw, Lisa Lead TB RN Clallam County Health and Human Services – Public Health 3604172428Gallentine, Madison RN, TB program Coordinator Clallam County Health and Human Services 36056526125/15/2024 7:26 AM
DetailsLast Recertification DateUpdateRecertification5/11/2023 7:44:51 AM5/15/2024 7:26:37 AM5/15/2024 7:26 AM
DetailsNature of Support: Support Received From DateUpdateRecertification1/1/2021 12:00:00 AM1/1/2020 12:00:00 AM5/11/2023 7:44 AM
ContactsPrimary ContactUpdateRecertificationMcLane, Karissa Garland Public Health Nurse Supervisor Clallam County Health & Human Services 3605652612Law, Lisa Lead TB RN Clallam County Health and Human Services – Public Health 36041724285/11/2023 7:44 AM
DetailsLast Recertification DateUpdateRecertification5/18/2022 7:28:46 AM5/11/2023 7:44:51 AM5/11/2023 7:44 AM
DetailsGrant NumberUpdateRecertification6NU52PS910221NU52PS9102215/11/2023 7:44 AM
AddressesMain AddressUpdateRecertification 223 E 4TH ST SUITE 14 PORT ANGELES, WA 98362 111 E. 3rd St. Port Angeles, WA 983625/18/2022 7:28 AM
DetailsNature of Support: Support Received To DateUpdateRecertification12/31/2021 12:00:00 AM12/31/2024 12:00:00 AM5/18/2022 7:28 AM
DetailsLast Recertification DateUpdateRecertification5/27/2021 2:02:32 PM5/18/2022 7:28:46 AM5/18/2022 7:28 AM
DetailsGrant NumberUpdateRecertification5NU52PS910221-02-006NU52PS9102215/18/2022 7:28 AM
DetailsNature of Support: In Kind Support DescriptionUpdateRecertification The Washington State TB Program receives 317 funding from the CDC Cooperative Agreement for our TB program. We do not these use federal TB dollars to purchase 340B medications, nor do our LHJs, we use state or local funding. Occasionally we apply for expiring CDC National Stockpile TB medications. If we receive any of these former Stockpile TB medications, they are stored and tracked separately from the 340B TB medications.5/27/2021 2:02 PM
DetailsNature of Support: Support Received From DateUpdateRecertification 1/1/2021 12:00:00 AM5/27/2021 2:02 PM
DetailsNature of Support: Support Received To DateUpdateRecertification 12/31/2021 12:00:00 AM5/27/2021 2:02 PM
ContactsPrimary ContactUpdateRecertificationJohnson, Ann M CHN Clallam County Health Department 3604172439McLane, Karissa Garland Public Health Nurse Supervisor Clallam County Health & Human Services 36056526125/27/2021 2:02 PM
DetailsLast Recertification DateUpdateRecertification6/4/2020 6:58:03 AM5/27/2021 2:02:32 PM5/27/2021 2:02 PM
DetailsGrant NumberUpdateRecertification6NU52PS910221-01-015NU52PS910221-02-005/27/2021 2:02 PM
DetailsNOFO NumberUpdateRecertification CDC-RFA-PS20-20015/27/2021 2:02 PM
DetailsLast Recertification DateUpdateRecertification5/22/2019 10:15:43 AM6/4/2020 6:58:03 AM6/4/2020 6:58 AM
DetailsGrant NumberUpdateRecertification5NU52PS004674-05-006NU52PS910221-01-016/4/2020 6:58 AM
DetailsEntity SubnameUpdateRecertification TB Program6/4/2020 6:58 AM
DetailsNature Of SupportDeleteRecertificationDirect Funding (dollars received from CDC or an intermediate organization) ()-()  5/22/2019 10:15 AM
DetailsLast Recertification DateUpdateRecertification5/16/2018 6:47:51 AM5/22/2019 10:15:43 AM5/22/2019 10:15 AM
DetailsGrant NumberUpdateRecertification6NU52PS04674-04-015NU52PS004674-05-005/22/2019 10:15 AM
ContactsAuthorizing OfficialUpdateChange RequestCarlson, Sherry TB Controller WA State Dept of Health 3602363528Pecha, Monica TB Controller Washington Department of Health 20641855446/28/2018 7:00 PM
ContactsPrimary ContactUpdateRecertificationDoran, David TB 3605652612Johnson, Ann M CHN Clallam County Health Department 36041724395/16/2018 6:47 AM
DetailsLast Recertification DateUpdateRecertification4/28/2017 12:00:00 AM5/16/2018 6:47:51 AM5/16/2018 6:47 AM
DetailsGrant NumberUpdateRecertification5NU52PS004674-03-006NU52PS04674-04-015/16/2018 6:47 AM
ContactsAuthorizing OfficialUpdate Carlson, Sherry TB Controller 3602363528Carlson, Sherry TB Controller WA State Dept of Health 36023635281/8/2018 10:36 AM
ContactsAuthorizing OfficialUpdate Allen, Sheanne TB CONTROLLER 3602363423Carlson, Sherry TB Controller 36023635285/17/2017 7:34 AM
AddressesMain AddressInsert   223 E 4TH ST SUITE 14 PORT ANGELES, WA 983624/28/2017 2:15 PM
ContactsPrimary ContactUpdate Johnson, Ann TB 3604172439Doran, David TB 36056526124/28/2017 2:15 PM
DetailsLast Recertification DateUpdate 3/1/2016 12:00:00 AM4/28/2017 12:00:00 AM4/28/2017 2:15 PM
DetailsGrant NumberUpdate TB-WA5NU52PS004674-03-004/28/2017 2:15 PM
ContactsAuthorizing OfficialInsert  Allen, Sheanne TB CONTROLLER 36023634236/3/2016 7:20 AM
AddressesShipping AddressInsert  Seattle King County Public Health Downtown Pharmacy 2124 4th Ave Seattle, WA 981213/1/2016 10:37 AM
DetailsNature Of SupportInsert  In-Kind products or services (see note below; must have been purchased with section 317 funds)3/1/2016 10:37 AM
DetailsLast Recertification DateUpdate 2/5/2015 12:00:00 AM3/1/2016 12:00:00 AM3/1/2016 10:37 AM
DetailsNature Of SupportInsert  Direct Funding (dollars received from CDC or an intermediate organization)2/5/2015 9:23 AM
ContactsPrimary ContactUpdate BURKS, IVE DIRECTOR 3604172329Johnson, Ann TB 36041724392/5/2015 9:23 AM
DetailsLast Recertification DateUpdate 2/10/2014 12:00:00 AM2/5/2015 12:00:00 AM2/5/2015 9:23 AM
ContactsPrimary ContactInsert  BURKS, IVE DIRECTOR 36041723292/10/2014 11:03 AM
DetailsLast Recertification DateUpdate 1/1/2012 12:00:00 AM2/10/2014 12:00:00 AM2/10/2014 11:03 AM
DetailsLast Recertification DateUpdate 1/1/2011 12:00:00 AM1/1/2012 12:00:00 AM11/7/2011 4:54 PM
DetailsLast Recertification DateInsert  1/1/2011 12:00:00 AM10/22/2010 6:37 PM
DetailsGrant NumberInsert  TB-WA10/22/2010 6:37 PM
Details340B IDInsert  TB98362210/22/2010 6:37 PM
DetailsIs Authorizing Official EHB DataInsert   10/22/2010 6:37 PM
DatesLast Date That 340B Drugs PurchasedInsert   10/22/2010 6:37 PM
DetailsMedicare Provider NumberInsert   10/22/2010 6:37 PM
DetailsEntity NameInsert  CLALLAM COUNTY HEALTH & HUMAN SERVICES10/22/2010 6:37 PM
DetailsProgram CodeInsert  TB10/22/2010 6:37 PM
DetailsEntity SubnameInsert   10/22/2010 6:37 PM
DatesParticipating Approval DateInsert  11/12/2004 12:00:00 AM10/22/2010 6:37 PM
DetailsStateInsert  Active10/22/2010 6:37 PM
DatesRegistration DateInsert  4/1/1996 12:00:00 AM10/22/2010 6:37 PM
DatesSigned By DateInsert  1/1/2011 12:00:00 AM10/22/2010 6:37 PM
DatesStart DateInsert  4/1/1996 12:00:00 AM10/22/2010 6:37 PM
TerminationsTermination CommentsInsert   10/22/2010 6:37 PM
TerminationsTermination DateInsert   10/22/2010 6:37 PM
TerminationsTermination Effective DateInsert   10/22/2010 6:37 PM
TerminationsTermination ReasonInsert   10/22/2010 6:37 PM