Covered Entity Details

DSH500129 TACOMA GENERAL/ALLENMORE HOSPITAL (Active) - information as of 6/26/2025 12:24:18 AM

Main Details

Name

TACOMA GENERAL/ALLENMORE HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

Rural

340B ID

DSH500129

Medicare Provider Number

500129

Additional Details

Current Program Status

Active

Registration Date

12/1/2005

Participating Start Date

12/1/2005

Participating Approval Date

12/1/2005

Last Recertification Date

8/18/2024

Contacts

Authorizing Official

MultiCare Health System
Timothy Wayne Lynch, Sr. VP, Chief Administrative Officer
(253) 403-2824

Primary Contact

MultiCare Health System
Cindy Wilson, Assistant Vice President - Pharmacy Compliance
(253) 403-2822

Addresses

Street Address

315 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405-4234

Billing Address

MultiCare Medical Center
PO Box 5299
MS 1313-5-AP
Tacoma, WA 98415-0299

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
03/20/2014: Termination recorded in error; site remained continuously eligible from participation start date.	03/31/2014

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
WA	1043908	1366556227,1841741311

Shipping Addresses

Shipping Address 1

Allenmore Hospital Pharmacy
1901 S. Union Ave
TACOMA, WA 98405

Shipping Address 2

MultiCare Medical Center ED Pharmacy
315 Martin Luther King Jr Way
Tacoma, WA 98405

Shipping Address 3

Multicare Medical Center Pharmacy
315 MARTIN LUTHER KING JR WAY
TACOMA, WA 98405

Shipping Address 4

Gig Harbor Multicare
4545 Point Fosdick Drive NW
Gig Harbor, WA 98335

Shipping Address 5

MultiCare Regional Cancer Center - Auburn
121 N. Division St. Suite 100
Auburn, WA 98000-4931

Shipping Address 6

MultiCare Regional Cancer Center - Puyallup
400 15th Ave SE
Puyallup, WA 98372

Shipping Address 7

Safecor Health, LLC
4060 Business Park Dr.
Columbus, OH 43204

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/17/2019	04/01/2019		04/01/2019
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/17/2019	04/01/2019		04/01/2019
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/17/2019	04/01/2019		04/01/2019
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	01/17/2019	04/01/2019	07/16/2020	07/19/2020
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/17/2019	04/01/2019	07/16/2020	07/19/2020
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/17/2019	04/01/2019	07/16/2020	07/19/2020
Contract Detail	AETNA SPECIALTY PHARMACY, LLC	503 SUNPORT LN		ORLANDO	FL	32809-7874	04/15/2019	07/01/2019	10/31/2024	10/31/2024
Contract Detail	ALBERTSON'S LLC	SAV-ON PHARMACY #493	104 MILLITARY ROAD SOUTH	TACOMA	WA	98444	04/15/2020	07/01/2020	04/14/2023	04/14/2023
Contract Detail	ALBERTSON'S LLC	SAFEWAY PHARMACY #3411	8611 STEILACOOM BLVD. SW	LAKEWOOD	WA	98498	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	ALBERTSON'S LLC	SAFEWAY PHARMACY #419	370 SW SEDGWICK RD	PORT ORCHARD	WA	98367	04/15/2020	07/01/2020	04/14/2023	04/14/2023
Contract Detail	ALBERTSON'S LLC	SAFEWAY PHARMACY #4406	11330 NW 51ST AVENUE	GIG HARBOR	WA	98332	04/16/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	ALBERTSON'S LLC	SAV-ON PHARMACY #3106	11012 CANYON RD E	PUYALLUP	WA	98373	04/16/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	ALBERTSON'S LLC	SAFEWAY PHARMACY #1268	3010 E 57TH AVENUE	SPOKANE	WA	99223	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	ALBERTSON'S LLC	SAFEWAY PHARMACY #2248	1304 N. LIBERTY LAKE RD.	LIBERTY LAKE	WA	99019	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	ARDON HEALTH, LLC	11835 NE GLENN WIDING DR		PORTLAND	OR	97220-9057	10/06/2020	01/01/2021		01/01/2021
Contract Detail	BARTELL DRUGS #06932	27055 PACIFIC HIGHWAY SOUTH		DES MOINES	WA	98198	04/18/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	BARTELL DRUGS #06934	12946 KENT KANGLEY ROAD		KENT	WA	98030-7940	04/18/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	BARTELL DRUGS #06939	5500 OLYMPIC DR STE C101		GIG HARBOR	WA	98335-1400	04/18/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	BARTELL DRUGS #06954	3601-6TH AVENUE		TACOMA	WA	98406	04/18/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	BARTELL DRUGS #06957	THE BARTELL DRUG COMPANY	1850 S MILDRED ST	TACOMA	WA	98465	04/18/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	07/17/2023	10/01/2023	06/14/2025	06/14/2025
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	04/15/2019	07/01/2019		07/01/2019
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	04/15/2019	07/01/2019		07/01/2019
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	04/15/2019	07/01/2019		07/01/2019
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/15/2019	07/01/2019		07/01/2019
Contract Detail	CENTERWELL PHARMACY, INC.	10737 MARKS WAY		MIRAMAR	FL	33025	01/11/2021	04/01/2021	03/15/2024	03/15/2024
Contract Detail	CENTERWELL PHARMACY, INC.	9843 WINDISCH RD		WEST CHESTER	OH	45069	01/11/2021	04/01/2021	03/15/2024	03/15/2024
Contract Detail	COSTLESS SENIOR SERVICES, INC	14216 92ND AVE NW STE B		GIG HARBOR	WA	98329	01/16/2024	04/01/2024		04/01/2024
Contract Detail	COVINGTON MULTICARE CLINIC PHARMACY	17700 SE 272ND ST STE 100		COVINGTON	WA	98042-4951	04/05/2025	07/01/2025		04/05/2025
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	04/07/2025	04/07/2025		04/16/2025
Contract Detail	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	01/05/2017	04/01/2017	07/03/2019	07/30/2019
Contract Detail	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	04/17/2020	07/01/2020		07/01/2020
Contract Detail	DIPLOMAT SPECIALTY PHARMACY OF SOUTHERN	DIPLOMAT SPECIALTY PHARMACY	1809 EXCISE AVENUE SUITE 204-208	ONTARIO	CA	91761	01/05/2017	04/01/2017	07/03/2019	07/30/2019
Contract Detail	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	01/17/2019	04/01/2019		04/01/2019
Contract Detail	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	01/17/2019	04/01/2019		04/01/2019
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	255 PHILLIPI ROAD	COLUMBUS	OH	43228	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	07/14/2018	10/01/2018	07/13/2018	08/03/2018
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	01/17/2019	04/01/2019	07/16/2020	07/19/2020
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	255 PHILLIPI ROAD	COLUMBUS	OH	43228	01/17/2019	04/01/2019		04/01/2019
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	01/17/2019	04/01/2019	07/16/2020	07/19/2020
Contract Detail	FRED MEYER #665	1201 VALLEY AVENUE E.		SUMNER	WA	98390	04/14/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER PHARMACY	26520 MAPLE VALLEY BLACK DIAMOND RD. SE		MAPLE VALLEY	WA	98038	04/14/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER PHARMACY #691	5502 POINT FOSDICK DRIVE NW		GIG HARBOR	WA	98335	04/15/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	ATTN: PHARMACY	7250 PACIFIC AVENUE SUITE M	TACOMA	WA	98408	04/07/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	16735 SE 272ND STREET		KENT	WA	98042	04/07/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	1100 NORTH MERIDIAN		PUYALLUP	WA	98371	04/07/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	10201 SE 240TH		KENT	WA	98031	04/09/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	1900 SE SEDGWICK ROAD		PORT ORCHARD	WA	98366-9558	04/09/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	555 TROSPER ROAD SW		TUMWATER	WA	98512	04/15/2020	07/01/2020	04/14/2023	04/14/2023
Contract Detail	FRED MEYER STORES	22303 MOUNTAIN HWY EAST		SPANAWAY	WA	98387	04/15/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	6305 BRIDGEPORT WAY WEST		UNIVERSITY PLACE	WA	98467	04/15/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	FRED MEYER PHARMACY #424	17404 MERIDIAN E	PUYALLUP	WA	98375-6234	04/15/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	301 EAST WALLACE-KNEELAND BLVD		SHELTON	WA	98584	04/15/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	6901 SOUTH 19TH STREET		TACOMA	WA	98466	04/15/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	ATTN: PHARMACY	4505 SO 19TH	TACOMA	WA	98405	04/15/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	FRED MEYER PHARMACY 214	12120 N DIVISION STREET	SPOKANE	WA	99218	04/13/2023	07/01/2023	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	5050 STATE HWY 303		BREMERTON	WA	98311	04/13/2023	07/01/2023	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	33702 21ST AVENUE SW		FEDERAL WAY	WA	98023	04/13/2023	07/01/2023	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	ATTN: PHARMACY	17801 108TH AVE SE	RENTON	WA	98055	04/13/2023	07/01/2023	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	400 SOUTH THOR ST		SPOKANE	WA	99202-5075	04/13/2023	07/01/2023	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES	FRED MEYER PHARMACY #391	12221 120TH AVE NE	KIRKLAND	WA	98034-6905	04/13/2023	07/01/2023	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES #215	25250 PACIFIC HWY SOUTH		KENT	WA	98032	04/09/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES INC	FRED MEYER PHARMACY 41	20901 STATE ROUTE 410 E	BONNEY LAKE	WA	98391	04/09/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES, INC	ATTN: PHARMACY	801 AUBURN WAY NORTH	AUBURN	WA	98002	04/07/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES, INC	FRED MEYER PHARMACY 186	700 SLEATER KINNEY RD SE	LACEY	WA	98503	04/07/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	FRED MEYER STORES, INC	FRED MEYER PHARMACY 351	15609 EAST SPRAGUE AVE	SPOKANE VALLEY	WA	99037	04/13/2023	07/01/2023	09/30/2024	09/30/2024
Contract Detail	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	04/07/2020	07/01/2020	08/11/2024	08/14/2024
Contract Detail	LINCOLN PHARMACY	821 SOUTH 38TH STREET		TACOMA	WA	98418	01/16/2024	04/01/2024		04/01/2024
Contract Detail	MEDCART SPECIALTY PHARMACY	32131 INDUSTRIAL RD.		LIVONIA	MI	48150	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	MULTICARE BONNEY LAKE PHARMACY	10004 204TH AVE E, STE 1100		BONNEY LAKE	WA	98391	04/17/2020	04/21/2020		04/21/2020
Contract Detail	MULTICARE CLINIC PHARMACY	521 Martin Luther King Jr Way		Tacoma	WA	98405	04/12/2016	07/01/2016	07/01/2016	04/01/2018
Contract Detail	MULTICARE CLINIC PHARMACY	521 Martin Luther King Jr Way		Tacoma	WA	98405	04/17/2020	04/21/2020		04/21/2020
Contract Detail	MULTICARE DEACONESS RETAIL PHARMACY	910 W 5TH AVE, STE 270		SPOKANE	WA	99204	04/15/2025	07/01/2025		04/15/2025
Contract Detail	MULTICARE GIG HARBOR PHARMACY	4545 POINT FOSDICK DR STE 250		GIG HARBOR	WA	98335	04/17/2020	04/21/2020		04/21/2020
Contract Detail	MULTICARE HOME INFUSION	315 MARTIN LUTHER KING JR WAY	PO BOX 5299	TACOMA	WA	98415-0299	07/13/2022	10/01/2022	09/30/2024	09/30/2024
Contract Detail	ONCOMED THE ONCOLOGY PHARMACY OF BUFFALO	D/B/A ONCO360	140 JOHN JAMES AUDUBON PKWY STE 101	AMHERST	NY	14228	01/10/2021	04/01/2021	04/17/2025	04/17/2025
Contract Detail	OPTUM FRONTIER THERAPIES II, LLC	6425 SANTA MARGARITA ST UNIT 110		LAS VEGAS	NV	89118-1913	10/08/2019	01/01/2020		01/01/2020
Contract Detail	OPTUM INFUSION SERVICES 404 LLC	2065 NE WILLIAMSON CT	STE B	BEND	OR	97701	04/17/2020	07/01/2020		07/01/2020
Contract Detail	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	07/08/2022	07/08/2022		07/08/2022
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	10/08/2019	01/01/2020		01/01/2020
Contract Detail	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	10/08/2019	01/01/2020	07/16/2020	07/19/2020
Contract Detail	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	07/08/2022	10/01/2022		10/01/2022
Contract Detail	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	10/08/2019	01/01/2020	07/16/2020	07/19/2020
Contract Detail	OPTUM PHARMACY 806, INC.	2288 AUBURN BLVD	STE. 102	SACRAMENTO	CA	95821-1618	10/08/2019	01/01/2020	07/16/2020	07/19/2020
Contract Detail	PREMIER PHARMACY SERVICES	410 CLOVERLEAF DR		BALDWIN PARK	CA	91706	04/07/2020	07/01/2020	01/25/2022	01/27/2022
Contract Detail	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	04/12/2019	07/01/2019	10/24/2022	11/08/2022
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	04/15/2019	07/01/2019		07/01/2019
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2926	1001 MADISON ST.	SEATTLE	WA	98104	04/17/2020	07/01/2020		07/01/2020
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #3129	1002 EAST MCDOWELL ROAD	PHOENIX	AZ	85006	10/11/2020	01/01/2021		01/01/2021
Contract Detail	PURDY COST LESS PRESCRIPTIONS	PHARMACY	14218 92ND AVE NW	GIG HARBOR	WA	98329-8710	01/16/2024	04/01/2024		04/01/2024
Contract Detail	QFC PHARMACY	1009 MONROE ST		ENUMCLAW	WA	98022	04/12/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	QUALITY FOOD CENTERS	DBA QFC, PHARMACY #101	NE 201 STATE RT 300 PO BOX 356	BELFAIR	WA	98528	04/09/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	07/17/2023	10/01/2023	06/14/2025	06/14/2025
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1844	215 WHITESELL STREET NW.	ORTING	WA	98360	04/09/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1246	6201 6TH AVENUE	TACOMA	WA	98406	04/10/2020	07/01/2020	04/14/2023	04/14/2023
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #0544	21301 STATE ROUTE 410 E	BONNEY LAKE	WA	98391	04/10/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1619	1109 E YELM AVE	YELM	WA	98597	04/10/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #3228	5616 176TH STREET EAST	PUYALLUP	WA	98375	04/10/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #3424	2411 N PROCTOR ST	TACOMA	WA	98406	04/10/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #0547	10105 224TH ST E	GRAHAM	WA	98338	04/12/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1471	26916 MAPLE VALLEY BLACK DIAMOND RD SE	MAPLE VALLEY	WA	98038-8322	04/12/2020	07/01/2020	04/14/2023	04/14/2023
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1437	1302 S 38TH ST	TACOMA	WA	98418	04/12/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1294	210 WASHINGTON AVENUE SOUTH	KENT	WA	98032	04/12/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #3321	4831 POINT FOSDICK DR NW	GIG HARBOR	WA	98335-1732	04/12/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1571	23961 NE STATE ROUTE 3	BELFAIR	WA	98528	04/14/2020	07/01/2020	04/14/2023	04/14/2023
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1594	707 S 56TH ST	TACOMA	WA	98408	04/14/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #0792	17023 SE 272ND ST	COVINGTON	WA	98042-4948	04/14/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #0422	611 S. MERIDIAN	PUYALLUP	WA	98371	04/14/2020	07/01/2020	04/14/2023	04/14/2023
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #2640	13308 MERIDIAN E	PUYALLUP	WA	98373	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1645	10223 GRAVELLY LAKE DRIVE SW	LAKEWOOD	WA	98499	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1555	1207 S 320TH ST	FEDERAL WAY	WA	98003-5379	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #0531	101 AUBURN WAY SOUTH	AUBURN	WA	98002	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #0329	1112 SOUTH M STREET	TACOMA	WA	98405	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #0494	152 ROOSEVELT AVE	ENUMCLAW	WA	98022	04/15/2020	07/01/2020	04/14/2023	04/14/2023
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1978	2637 N. PEARL STREET	TACOMA	WA	98407	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1798	11501 CANYON ROAD E.	PUYALLUP	WA	98373	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #3545	900 MERIDIAN E STE 12	MILTON	WA	98354-7002	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	HAGGEN PHARMACY #3438	1406 LAKE TAPPS PKWY SE	AUBURN	WA	98092	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1436	1624 72ND ST E	TACOMA	WA	98404	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1966	13101 S.E. KENT KANGLEY RD	KENT	WA	98030-7915	04/15/2020	07/01/2020	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1242	2509 E 29TH AVE	SPOKANE	WA	99223	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1173	1243 MARVIN RD NE	LACEY	WA	98516-4701	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1495	1129 HARRISON AVE	CENTRALIA	WA	98531	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1524	1401 NE MCWILLIAMS RD	BREMERTON	WA	98311	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #2729	708 SHAW RD	PUYALLUP	WA	98372-5276	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1473	14020 E SPRAGUE AVE	SPOKANE VALLEY	WA	99216	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #1740	2710 1ST STREET	CHENEY	WA	99004	04/13/2023	07/01/2023	08/11/2024	08/11/2024
Contract Detail	SANTA BARBARA SPECIALTY PHARMACY LLC	4690 CARPINTERIA AVE STE B		CARPINTERIA	CA	93013	07/17/2023	10/01/2023	06/14/2025	06/14/2025
Contract Detail	SINA DRUG LLC	D/B/A ONCO 360	13410 EASTPOINT CENTRE DR STE 101	LOUISVILLE	KY	40223	01/10/2021	04/01/2021	04/17/2025	04/17/2025
Contract Detail	SINA DRUG LLC	DBA ONCO360	1985 MARCUS AVE STE 120	NEW HYDE PARK	NY	11042	01/10/2021	04/01/2021	04/17/2025	04/17/2025
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5262	1323 EAST MAIN AVENUE	PUYALLUP	WA	98372	04/16/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5255	4818 POINT FOSDICK DR.,NW	GIG HARBOR	WA	98335	04/16/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5269	1912 NORTH PEARL STREET	TACOMA	WA	98406	04/16/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5271	7041 PACIFIC AVENUE	TACOMA	WA	98408	04/16/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5276	1850 SOUTH MILDRED STREET	TACOMA	WA	98465	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5275	3840 BRIDGEPORT WAY WEST	UNIVERSITY PLACE	WA	98466	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5274	15801 PACIFIC AVENUE	TACOMA	WA	98444	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5172	1509 AUBURN WAY SOUTH	AUBURN	WA	98002	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5256	900 EAST MERIDIAN SUITE 23	MILTON	WA	98354	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #6493	9502 176TH STREET EAST	PUYALLUP	WA	98375	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #6194	22311 MOUNTAIN HIGHWAY EAST	SPANAWAY	WA	98387	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5264	11220 CANYON ROAD EAST	PUYALLUP	WA	98373	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #6232	12811 MERIDIAN STREET EAST	PUYALLUP	WA	98373	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5171	1231 AUBURN WAY NORTH	AUBURN	WA	98002	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5277	5700 100TH STREET SW STE 100	LAKEWOOD	WA	98499	04/17/2020	07/01/2020	09/30/2024	09/30/2024
Contract Detail	TIM'S PHARMACY AND GIFT SHOP	106 1ST ST S		YELM	WA	98597-7700	01/16/2024	04/01/2024		04/01/2024
Contract Detail	VASHON PHARMACY INC	17617 VASHON HWY SW		VASHON	WA	98070	01/16/2024	04/01/2024		04/01/2024
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-2249	1601 NW LOUISIANA AVE		CHEHALIS	WA	98532	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-2325	3497 BETHEL ROAD SE		PORT ORCHARD	WA	98366	04/15/2019	07/01/2019	07/16/2020	07/19/2020
Contract Detail	WAL-MART PHARMACY 10-2325	3497 BETHEL ROAD SE		PORT ORCHARD	WA	98366	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-2385	762 OUTLET COLLECTION DR SW		AUBURN	WA	98001	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-2403	310 31ST AVE SE		PUYALLUP	WA	98374-1232	04/15/2019	07/01/2019	07/16/2020	07/19/2020
Contract Detail	WAL-MART PHARMACY 10-2403	310 31ST AVE SE		PUYALLUP	WA	98374-1232	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-2539	15727 EAST BROADWAY		SPOKANE VALLEY	WA	99037	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-2549	9212 NORTH COLTON STREET		SPOKANE (NORTH)	WA	99218	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-2571	1900 SO. 314TH STREET		FEDERAL WAY	WA	98003	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-2865	2301 WEST WELLESLEY AVENUE		SPOKANE (W)	WA	99205	04/06/2023	07/01/2023	09/02/2024	09/02/2024
Contract Detail	WAL-MART PHARMACY 10-3218	20307 MOUNTAIN HWY., EAST		SPANAWAY	WA	98387	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-3525	16502 MERIDAN AVE EAST		PUYALLUP	WA	98375	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-3531	1401 GALAXY DRIVE N.E.		LACEY	WA	98516-4746	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-3537	7001 BRIDGEPORT WAY WEST		LAKEWOOD	WA	98499	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-3705	17100 STATE ROUTE 507 SE		YELM	WA	98597	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-3794	34520 16TH AVENUE SOUTH		FEDERAL WAY	WA	98003	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-4137	1965 S. UNION AVE		TACOMA	WA	98405	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-5041	19205 SR 410 EAST		BONNEY LAKE	WA	98391	04/15/2019	07/01/2019	07/16/2020	07/19/2020
Contract Detail	WAL-MART PHARMACY 10-5041	19205 SR 410 EAST		BONNEY LAKE	WA	98391	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-5073	17432 SOUTHEAST 270TH PLACE		COVINGTON	WA	98042	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-5883	5025 E SPRAGUE AVE		SPOKANE VALLEY	WA	99212	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/15/2019	07/01/2019	09/01/2024	09/01/2024
Contract Detail	WAL-MART.PHARMACY 10-4394	1221 S. HAYFORD RD.		SPOKANE	WA	99224	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05698	3099 BETHEL RD SE	PORT ORCHARD	WA	98366	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07480	1701 AUBURN WAY SOUTH	AUBURN	WA	98002-6348	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12168	3929 KITSAP WAY	BREMERTON	WA	98312-3451	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04064	8224 STEILACOOM BLVD. SW	LAKEWOOD	WA	98498	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06901	28817 MILITARY ROAD SOUTH	FEDERAL WAY	WA	98003	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS #11527	2024 6TH AVE.	TACOMA	WA	98403	04/12/2019	07/01/2019	04/17/2023	06/20/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06260	729 MERIDIAN AVE EAST	EDGEWOOD	WA	98371-1041	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #16403	1409 11TH AVE.	SEATTLE	WA	98122	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03519	4315 6TH AVE	TACOMA	WA	98406	04/12/2019	07/01/2019	06/19/2023	06/20/2023
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07700	34008 HOYT RD SW	FEDERAL WAY	WA	98023	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03518	25605 104TH AVE SE	KENT	WA	98030	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07594	1416 HARVEY ROAD NE	AUBURN	WA	98002-3308	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05697	15225 PACIFIC AVE S	TACOMA	WA	98444	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS #10304	14308 MERIDIAN E	PUYALLUP	WA	98373-5613	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04760	12105 PACIFIC AVENUE S.	TACOMA	WA	98444	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03519	4315 6TH AVE	TACOMA	WA	98406	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06083	4540 LACEY BLVD SE	LACEY	WA	98503	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07908	27130 172ND AVE SE	COVINGTON	WA	98042-1759	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05150	3737 PACIFIC AVE	TACOMA	WA	98418-7827	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06814	10302 SUNRISE BLVD EAST	PUYALLUP	WA	98374-8833	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06102	4404 S. MERIDIAN	PUYALLUP	WA	98373-3544	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07136	1350 GARRETT STREET	ENUMCLAW	WA	98022	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS #15203	26705 MAPLE VALLEY BLACK DIAMOND RD SE	MAPLE VALLEY	WA	98038-8390	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05951	11509 CANYON ROAD EAST	PUYALLUP	WA	98373	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03723	7451 CIRQUE DR. W.	UNIVERSITY PLACE	WA	98467	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #21152	1 N TACOMA AVE STE 101	TACOMA	WA	98403	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03581	8405 PACIFIC AVENUE	TACOMA	WA	98444	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS #07173	22320 MERIDIAN E	GRAHAM	WA	98338	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09590	5602 PACIFIC AVE	TACOMA	WA	98408-7514	04/12/2019	07/01/2019	04/10/2024	04/10/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12910	4840 BORGEN BLVD	GIG HARBOR	WA	98332	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06917	8333 MARTIN WAY EAST	LACEY	WA	98516-5808	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03514	9505 BRIDGEPORT WAY SW	TACOMA	WA	98499	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREEN CO.	DBA: WALGREENS #10395	1610 NW LOUISIANA AVE.	CHEHALIS	WA	98532	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07137	2650 BRIDGEPORT WAY WEST	UNIVERSITY PLACE	WA	98466-4720	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07677	1502 LAKE TAPPS PKWY SE	AUBURN	WA	98092	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09423	23003 PACIFIC HWY S	DES MOINES	WA	98198-7269	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06422	9709 SILVERDALE WAY NW	SILVERDALE	WA	98383-9445	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06304	27112 132ND AVE SE	KENT	WA	98042	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07356	3540 N PEARL STREET	TACOMA	WA	98407-2607	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	04/12/2019	07/01/2019	06/20/2023	06/20/2023
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/12/2019	07/01/2019	05/21/2020	05/27/2020
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	04/12/2019	07/01/2019		07/01/2019
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/07/2025	04/07/2025		04/16/2025
Contract Detail	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	04/12/2019	07/01/2019	04/07/2025	04/07/2025
Contract Detail	WALMART PHARMACY 10-4757	5110 YELM HWY. SE		LACEY	WA	98503	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WALMART PHARMACY 10-7229	1110 SUNLAND PARK DRIVE		EL PASO	TX	79922	04/06/2023	07/01/2023	09/01/2024	09/01/2024
Contract Detail	WASHINGTON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16123	3320 S 23RD ST	TACOMA	WA	98405	04/15/2019	07/01/2019		07/01/2019
Contract Detail	WASHINGTON CVS PHARMACY, L.L.C.	CVS PHARMACY # 17064	2201 S COMMONS	FEDERAL WAY	WA	98003	04/15/2019	07/01/2019		07/01/2019
Contract Detail	WASHINGTON CVS PHARMACY, L.L.C.	CVS/PHARMACY # 17073	9400 192ND AVE E	BONNEY LAKE	WA	98391	04/15/2019	07/01/2019		07/01/2019
Contract Detail	WASHINGTON CVS PHARMACY, L.L.C.	CVS/PHARMACY # 11023	9400 GRAVELLY LAKE DR SW	LAKEWOOD	WA	98499	04/15/2019	07/01/2019		07/01/2019
Contract Detail	WASHINGTON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16560	11400 51ST AVE NW	GIG HARBOR	WA	98332	04/15/2019	07/01/2019		07/01/2019
Contract Detail	WASHINGTON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16203	26301 104TH AVE SE	KENT	WA	98030	04/15/2019	07/01/2019		07/01/2019
Contract Detail	WASHINGTON CVS PHARMACY, L.L.C.	CVS PHARMACY # 17219	10302 156TH ST E	PUYALLUP	WA	98374	04/15/2019	07/01/2019		07/01/2019
Contract Detail	WASHINGTON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16124	3310 S MERIDIAN	PUYALLUP	WA	98373	04/15/2019	07/01/2019		07/01/2019
Contract Detail	WASHINGTON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16130	5618 LAKEWOOD TOWN CENTER BLVD SW	LAKEWOOD	WA	98499	04/15/2019	07/01/2019		07/01/2019
Contract Detail	YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIAT	MULTICARE CANCER CENTER PHARMACY - NORTH	808 N. 39TH AVE	YAKIMA	WA	98902	01/16/2024	04/01/2024		04/01/2024

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH500129AA	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	AHC AMBULATORY INFUSION SUITE	3124 S. 19th Street	Tacoma	WA	Active
DSH500129AC	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MultiCare Obgyn Associate II Clinic	521 Martin Luther King Jr Way	Tacoma	WA	Terminated
DSH500129AE	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	CT Scan Allenmore C	3124 South 19th St Suite 100	Tacoma	WA	Active
DSH500129AF	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MRI Allenmore C	3124 South 19th St Suite 100	Tacoma	WA	Active
DSH500129AG	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Imaging Services Allenmore C	3124 South 19th St Suite 100	Tacoma	WA	Active
DSH500129AH	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Nuclear Medicine Allenmore C	3124 South 19th St Suite 100	Tacoma	WA	Active
DSH500129AJ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Heart and Lung Center	1901 South Union Ave	Tacoma	WA	Active
DSH500129AK	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV SHORT STAY UNIT	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129AL	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD CT SCAN	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AM	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH PACU	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AN	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH OR	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AP	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD RADIATION THERAPY	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AQ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD MRI	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AR	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD DIABETES SVCS	4545 Point Fosdick Rd NW	Gig Harbor	WA	Active
DSH500129AS	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH HSD DIAGNOSTIC IMAGING	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AT	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH PHARMACEUTICAL RESOURCE CLINIC	4545 Point Fosdick Drive NW, STE 260	Gig Harbor	WA	Terminated
DSH500129AU	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH ONC ACUPUNCTURE	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AV	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH MULTI-SPECIALTY PROCEDURE CENTER	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AW	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH SURGICAL ADMISSION UNIT	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129AX	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - GH ONC BREAST SURGEONS	4545 Point Fosdick Drive NW	Gig Harbor	WA	Active
DSH500129BA	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB HSD RADIATION THERAPY	121 North Division St #100	AUBURN	WA	Active
DSH500129BB	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB ONC BREAST SURGEONS	121 North Division St #100	AUBURN	WA	Active
DSH500129BC	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB HSD HEM/ONC LAB	121 North Division St #100	AUBURN	WA	Terminated
DSH500129BD	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB ONC INTERNAL MEDICINE	121 North Division St #100	AUBURN	WA	Active
DSH500129BF	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV PACU 1	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BG	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV PACU 2	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BH	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD MRI	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BK	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD ULTRASOUND	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BM	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV EMERGENCY DEPARTMENT	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129BP	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH DIAGNOSTIC IMAGING	1901 South Union	TACOMA	WA	Active
DSH500129BQ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG INTERVENTIONAL ENDOSCOPY	316 Martin Luther King Jr Way	TACOMA	WA	Active
DSH500129BR	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH INTERVENTIONAL ENDOSCOPY	1901 South Union	TACOMA	WA	Active
DSH500129BS	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH ULTRASOUND	1901 South Union	TACOMA	WA	Active
DSH500129BT	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG WG WESTGATE LAB	2209 North Pearl Suite 100	TACOMA	WA	Terminated
DSH500129BU	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AHC CLAB ALLENMORE C LAB	3124 S 19th Street	TACOMA	WA	Terminated
DSH500129BV	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG BAKER DIAGNOSTIC IMAGING	316 Martin Luther King Jr Way	TACOMA	WA	Active
DSH500129BW	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG TRAUMA FOLLOWUP - BAKER	316 MARTIN LUTHER KING JR.WAY	TACOMA	WA	Active
DSH500129BX	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - MB LAB	317 Martin Luther King Jr Way	TACOMA	WA	Terminated
DSH500129BY	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG LAKEWOOD DIABETES SERVICES	735 12th Street SE	AUBURN	WA	Terminated
DSH500129BZ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV OR	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129CA	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - TG SPANAWAY DIABETES SERVICES	225 176th St S	SPANAWAY	WA	Terminated
DSH500129CB	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD DIAGNOSTIC IMAGING	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129CC	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH DIABETES SERVICES	3124 South 19th, Suite 140	TACOMA	WA	Terminated
DSH500129CD	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH NUCLEAR MED	1901 South Union	TACOMA	WA	Active
DSH500129CE	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD CT SCAN	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129CF	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH ECHO	1901 South Union-	TACOMA	WA	Active
DSH500129CG	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - COV HSD DIABETES SVCS	17700 SE 272nd St.	COVINGTON	WA	Terminated
DSH500129CH	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AH Medication Management Clinic	1901 South Union- BUILDING B, SUITE #7009	TACOMA	WA	Active
DSH500129CJ	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE HEALTH SYSTEM - AUB HSD DIABETES SERVICES	735 12th Street SE	AUBURN	WA	Terminated
DSH500129CK	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MultiCare Neuroscience & Sleep Medicine - TG Neurology	915 6th Avenue	Tacoma	WA	Active
DSH500129CL	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Multicare Rheumatology Specialists - Multicare Rheumatology Specialists	1901 S. Cedar St.	Tacoma	WA	Active
DSH500129CM	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MultiCare Neuroscience & Sleep Medicine - TG NEUROSURGERY CLINIC	915 6TH Ave	Tacoma	WA	Active
DSH500129CN	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Tacoma General Emergency - Federal Way - TG Off Campus ED - FW	29805 Pacific Hwy S	Federal Way	WA	Active
DSH500129CP	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Hospital PET/CT - AHC PET/CT	3124 S 19th	Tacoma	WA	Active
DSH500129E	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Tacoma Family Medicine Clinic	521 MARTIN LUTHER KING JR WAY	TACOMA	WA	Terminated
DSH500129F	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE REGIONAL CANCER CENTER - GIG HARBOR	4545 POINT FOSDICK DR NW Suite 215	GIG HARBOR	WA	Active
DSH500129G	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE REGIONAL CANCER CENTER - AUBURN	121 N. Division Street Suite 200	AUBURN	WA	Active
DSH500129H	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	MULTICARE REGIONAL CANCER CENTER - PUYALLUP	400 15TH AVE SE	PUYALLUP	WA	Active
DSH500129J	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Baker Center Ambulatory Surgery Center	316 Martin Luther King Jr Way	Tacoma	WA	Active
DSH500129K	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Day Surgery of Tacoma-PACU	316 Martin Luther King Jr Way	Tacoma	WA	Active
DSH500129L	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Interventional Pain Management	316 Martin Luther King Jr Way	Tacoma	WA	Active
DSH500129M	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	OB Access Clinic	521 Martin Luther King Jr Way	Tacoma	WA	Terminated
DSH500129Q	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Campus	1901 S Union Ave	Tacoma	WA	Active
DSH500129R	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Short Stay Unit	1901 S Union Ave	Tacoma	WA	Active
DSH500129S	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Emergency Department	1901 S Union Ave	Tacoma	WA	Active
DSH500129T	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Surgery (Operating Room)	1901 S Union Ave	Tacoma	WA	Active
DSH500129U	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore PACU	1901 S Union Ave	Tacoma	WA	Active
DSH500129W	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore MRI	1901 S Union Ave	Tacoma	WA	Active
DSH500129X	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Radiology	1901 S Union Ave	Tacoma	WA	Active
DSH500129Y	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore CT Scan	1901 S Union Ave	Tacoma	WA	Active
DSH500129Z	Child	DSH	TACOMA GENERAL/ALLENMORE HOSPITAL	Allenmore Interventional Radiology	1901 S Union Ave	Tacoma	WA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	9/5/2023 2:13:04 PM	8/18/2024 7:50:34 PM	8/18/2024 7:50 PM
Details	Last Recertification Date	Update	Recertification	9/12/2022 6:58:49 AM	9/5/2023 2:13:04 PM	9/5/2023 2:13 PM
Contacts	Authorizing Official	Update	AO Change Request	Chang, Florence President MULTICARE HEALTH SYSTEM 2534037355	Lynch, Timothy Wayne Sr. VP, Chief Administrative Officer MultiCare Health System 2534032824	11/4/2022 8:08 AM
Details	Last Recertification Date	Update	Recertification	9/8/2021 3:08:27 PM	9/12/2022 6:58:49 AM	9/12/2022 6:58 AM
Addresses	Shipping Address	Insert	Change Request		Safecor Health, LLC 4060 Business Park Dr. Columbus, OH 43204	6/16/2022 6:46 AM
Contacts	Authorizing Official	Update	Profile Change Request	Chang, Florence Executive Vice President MULTICARE HEALTH SYSTEM 2534037355	Chang, Florence President MULTICARE HEALTH SYSTEM 2534037355	4/18/2022 7:16 AM
Contacts	Primary Contact	Update	Profile Change Request	Wilson, Cindy Executive Director Pharmacy Compliance MultiCare Health System 2534032822	Wilson, Cindy Assistant Vice President - Pharmacy Compliance MultiCare Health System 2534032822	4/15/2022 12:38 PM
Contacts	Primary Contact	Update	Profile Change Request	Wilson, Cindy Director Pharmacy Compliance MultiCare Health System 2534032822	Wilson, Cindy Executive Director Pharmacy Compliance MultiCare Health System 2534032822	12/1/2021 11:55 AM
Contacts	Primary Contact	Update	Change Request	Campanella, Maria Director 340B Program MultiCare Health System 2534038314	Wilson, Cindy Director Pharmacy Compliance MultiCare Health System 2534032822	11/12/2021 8:09 AM
Contacts	Primary Contact	Update	Recertification	Wilson, Cindy Director Pharmacy Compliance MultiCare Health System 2534032822	Campanella, Maria Director 340B Program MultiCare Health System 2534038314	9/8/2021 3:08 PM
Details	Last Recertification Date	Update	Recertification	9/9/2020 1:53:03 AM	9/8/2021 3:08:27 PM	9/8/2021 3:08 PM
Addresses	Billing Address	Update	Change Request	MultiCare Medical Center 737 South Fawcett MS 737-4-AP Tacoma, WA 98415	MultiCare Medical Center PO Box 5299 MS 1313-5-AP Tacoma, WA 98415-0299	7/19/2021 2:28 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/19/2021 2:28 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1043908	7/19/2021 2:28 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		WA	7/19/2021 2:28 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	500129 (WA)		7/19/2021 2:28 PM
Contacts	Primary Contact	Update	Change Request	Scheer, LeeAnn Director of Pharmacy Supply Chain and 340B Multicare Health System 5127898341	Wilson, Cindy Director Pharmacy Compliance MultiCare Health System 2534032822	7/12/2021 8:46 AM
Contacts	Primary Contact	Update	Profile Change Request	Scheer, LeeAnn Director of Pharmacy Supply Chain and 340B Multicare Health System 2534032934	Scheer, LeeAnn Director of Pharmacy Supply Chain and 340B Multicare Health System 5127898341	12/4/2020 7:15 PM
Medicaid Billing	NPI: State	Update	Recertification		WA	9/9/2020 1:53 AM
Medicaid Billing	NPI: State	Update	Recertification		WA	9/9/2020 1:53 AM
Details	Last Recertification Date	Update	Recertification	9/18/2019 7:18:20 AM	9/9/2020 1:53:03 AM	9/9/2020 1:53 AM
Addresses	Shipping Address	Insert	Change Request		MultiCare Regional Cancer Center - Auburn 121 N. Division St. Suite 100 Auburn, WA 98000-4931	6/2/2020 7:11 AM
Addresses	Shipping Address	Insert	Change Request		MultiCare Regional Cancer Center - Puyallup 400 15th Ave SE Puyallup, WA 98372	6/2/2020 7:11 AM
Addresses	Shipping Address	Delete	Change Request	Covington Multicare Hospital Pharmacy 17700 SE 272nd Street Covington, WA 98042		6/1/2020 6:57 AM
Contacts	Primary Contact	Update	Change Request	Johnson, Jae Pharmacy 340B Analyst Multicare Health Systems 2534035541	Scheer, LeeAnn Director of Pharmacy Supply Chain and 340B Multicare Health System 2534032934	3/10/2020 1:30 PM
Contacts	Primary Contact	Update	Change Request	Aflatooni, Vafa Director Pharmacy Supply Chain and 340B MultiCare Health System 2534032082	Johnson, Jae Pharmacy 340B Analyst Multicare Health Systems 2534035541	11/27/2019 10:47 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1093802290 ( )		11/8/2019 12:38 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1306933213 ( )		11/8/2019 12:38 AM
Details	Last Recertification Date	Update	Recertification	8/27/2018 1:44:17 PM	9/18/2019 7:18:20 AM	9/18/2019 7:18 AM
Contacts	Primary Contact	Update	Profile Change Request	Aflatooni, Vafa Pharmacy Manager MultiCare Health System 2534032082	Aflatooni, Vafa Director Pharmacy Supply Chain and 340B MultiCare Health System 2534032082	5/15/2019 4:37 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1093802290	12/11/2018 12:09 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1306933213	12/11/2018 12:09 AM
Details	Last Recertification Date	Update	Recertification	11/16/2017 8:09:17 AM	8/27/2018 1:44:17 PM	8/27/2018 1:44 PM
Addresses	Shipping Address	Insert	Change Request		Covington Multicare Hospital Pharmacy 17700 SE 272nd Street Covington, WA 98042	6/12/2018 7:16 AM
Addresses	Shipping Address	Insert	Change Request		Gig Harbor Multicare 4545 Point Fosdick Drive NW Gig Harbor, WA 98335	6/12/2018 7:16 AM
Contacts	Primary Contact	Update	Change Request	Rowe, Tom Director, Phamacy Acute Care MultiCare Health System 2534031629	Aflatooni, Vafa Pharmacy Manager MultiCare Health System 2534032082	1/18/2018 1:35 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	11/24/2017 7:19 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		500129	11/24/2017 7:19 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		WA	11/24/2017 7:19 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1366556227	11/24/2017 7:19 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1841741311	11/24/2017 7:19 PM
Details	Last Recertification Date	Update	Recertification	8/15/2016 12:00:00 AM	11/16/2017 8:09:17 AM	11/16/2017 8:09 AM
Contacts	Primary Contact	Update	Profile Change Request	Rowe, Tom Pharmacy Clinical Manager MultiCare Health System 2534031629	Rowe, Tom Director, Phamacy Acute Care MultiCare Health System 2534031629	10/18/2017 8:53 PM
Contacts	Primary Contact	Update		Rowe, Tom Pharmacy Clinical Manager 2534031629	Rowe, Tom Pharmacy Clinical Manager MultiCare Health System 2534031629	10/18/2017 8:49 PM
Contacts	Authorizing Official	Update		Chang, Florence Executive Vice President 2534037355	Chang, Florence Executive Vice President MULTICARE HEALTH SYSTEM 2534037355	10/9/2017 5:21 PM
Contacts	Authorizing Official	Update		BROWN, GEORGE J. VP, COO 2534031000	Chang, Florence Executive Vice President 2534037355	2/15/2017 11:03 AM
Contacts	Primary Contact	Insert			Rowe, Tom Pharmacy Clinical Manager 2534031629	9/7/2016 5:43 PM
Addresses	Main Address	Insert			315 MARTIN LUTHER KING JR WAY TACOMA, WA 98405-4234	8/15/2016 7:18 PM
Details	Last Recertification Date	Update		8/19/2015 12:00:00 AM	8/15/2016 12:00:00 AM	8/15/2016 7:18 PM
Addresses	Billing Address	Insert			MultiCare Medical Center 737 South Fawcett MS 737-4-AP Tacoma, WA 98415	12/28/2015 8:16 AM
Addresses	Shipping Address	Insert			Allenmore Hospital Pharmacy 1901 S. Union Ave TACOMA, WA 98405	12/28/2015 8:16 AM
Addresses	Shipping Address	Insert			Multicare Medical Center Pharmacy 315 MARTIN LUTHER KING JR WAY TACOMA, WA 98405	12/28/2015 8:16 AM
Addresses	Shipping Address	Insert			MultiCare Medical Center ED Pharmacy 315 Martin Luther King Jr Way Tacoma, WA 98405	12/28/2015 8:16 AM
Details	Last Recertification Date	Update		8/27/2014 12:00:00 AM	8/19/2015 12:00:00 AM	8/20/2015 2:41 PM
Details	Last Recertification Date	Update		9/12/2013 12:00:00 AM	8/27/2014 12:00:00 AM	8/27/2014 7:45 AM
Details	State	Update		Terminated	Active	3/31/2014 12:59 PM
Terminations	Termination Date	Update		4/1/2014 12:00:00 AM		3/31/2014 12:59 PM
Terminations	Termination Reason	Update		Other		3/31/2014 12:59 PM
Details	Comments Public	Insert			03/20/2014: Termination recorded in error; site remained continuously eligible from participation start date.	3/31/2014 12:59 PM
Details	State	Update		Active	Terminated	3/20/2014 5:43 AM
Terminations	Termination Date	Update			4/1/2014 12:00:00 AM	3/20/2014 5:43 AM
Terminations	Termination Reason	Update			Other	3/20/2014 5:43 AM
Details	Last Recertification Date	Update		7/1/2012 12:00:00 AM	9/12/2013 12:00:00 AM	9/12/2013 11:29 AM
Details	Last Recertification Date	Update			7/1/2012 12:00:00 AM	5/18/2012 12:09 PM
Details	Entity Subname	Update		MULTICARE MEDICAL CENTER PHARMACY		5/18/2012 12:09 PM
Contacts	Authorizing Official	Insert			BROWN, GEORGE J. VP, COO 2534031000	12/21/2011 11:26 AM
Details	Last Recertification Date	Insert				12/1/2005 3:08 PM
Details	Grant Number	Insert				12/1/2005 3:08 PM
Details	340B ID	Insert			DSH500129	12/1/2005 3:08 PM
Details	Is Authorizing Official EHB Data	Insert				12/1/2005 3:08 PM
Dates	Last Date That 340B Drugs Purchased	Insert				12/1/2005 3:08 PM
Details	Medicare Provider Number	Insert			500129	12/1/2005 3:08 PM
Details	Entity Name	Insert			TACOMA GENERAL/ALLENMORE HOSPITAL	12/1/2005 3:08 PM
Details	Program Code	Insert			DSH	12/1/2005 3:08 PM
Details	Entity Subname	Insert			MULTICARE MEDICAL CENTER PHARMACY	12/1/2005 3:08 PM
Dates	Participating Approval Date	Insert			12/1/2005 12:00:00 AM	12/1/2005 3:08 PM
Details	State	Insert			Active	12/1/2005 3:08 PM
Dates	Registration Date	Insert			12/1/2005 12:00:00 AM	12/1/2005 3:08 PM
Dates	Signed By Date	Insert			11/27/2005 12:00:00 AM	12/1/2005 3:08 PM
Dates	Start Date	Insert			12/1/2005 12:00:00 AM	12/1/2005 3:08 PM
Terminations	Termination Comments	Insert				12/1/2005 3:08 PM
Terminations	Termination Date	Insert				12/1/2005 3:08 PM
Terminations	Termination Effective Date	Insert				12/1/2005 3:08 PM
Terminations	Termination Reason	Insert				12/1/2005 3:08 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

Parent/Child

History