Covered Entity Details

CHC08773-03 Unity Care Northwest (Active) - information as of 6/6/2025 4:23:24 AM

Main Details

Name

Unity Care Northwest

Subdivision Name

UCNW North Whatcom

Type

HRSA-Funded Health Center

Site ID

BPS-H80-027565

340B ID

CHC08773-03

Grant Number

H80CS08773

Additional Details

Current Program Status

Active

Registration Date

12/10/2009

Participating Start Date

1/1/2010

Participating Approval Date

12/21/2009

Last Recertification Date

2/27/2025

Contacts

Authorizing Official

Unity Care Northwest
Jodi Joyce, Chief Executive Officer
(360) 676-6177 Ext: 1232

Primary Contact

Unity Care Northwest
Lisa Jayne Nelson, Chief Pharmacy Officer
(360) 788-2682

Addresses

Street Address

6060 Portal Way
Ferndale, WA 98248

Billing Address

Unity Care Northwest
1616 Cornwall Ave Ste 205
Bellingham, WA 98225

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

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	2127891,2030572,2127212	1386089761,1801359112,1376013250

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	07/15/2024	10/01/2024		10/01/2024
Contract Detail	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	07/15/2024	10/01/2024		10/01/2024
Contract Detail	GENOA HEALTHCARE LLC	3645 E MCLEOD RD STE P-1		BELLINGHAM	WA	98226	07/15/2024	10/01/2024		10/01/2024
Contract Detail	HAGGEN		HAGGEN FOOD & PHARMACY #163 1815 MAIN STREET	FERNDALE	WA	98248	03/08/2010	03/08/2010	12/31/2017	11/06/2018
Contract Detail	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	07/15/2024	10/01/2024		10/01/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #6452	5655 3RD AVE PO BOX 2568	FERNDALE	WA	98248-2568	07/15/2024	10/01/2024		10/01/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5242	8090 GUIDE MERIDIAN ROAD.	LYNDEN	WA	98264	07/15/2024	10/01/2024		10/01/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5237	3227 NORTHWEST AVENUE	BELLINGHAM	WA	98225	07/15/2024	10/01/2024		10/01/2024
Contract Detail	THRIFTY PAYLESS, INC.	RITE AID #5241	1195 BOBLETT STREET	BLAINE	WA	98230	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART PHARMACY 10-2450	4420 MERIDIAN STREET		BELLINGHAM	WA	98226	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07390	1070 E SUNSET DRIVE	BELLINGHAM	WA	98226-3509	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS #16095	125 SAMISH WAY	BELLINGHAM	WA	98225	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05911	4090 GUIDE MERIDIAN RD	BELLINGHAM	WA	98226	07/15/2024	10/01/2024		10/01/2024
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07782	1901 MAIN ST	FERNDALE	WA	98248-9451	07/15/2024	10/01/2024		10/01/2024
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	07/15/2024	10/01/2024		10/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC08773-00	Active	BPS-H80-002470	Unity Care Northwest	UCNW 220 Unity	220 Unity St	Bellingham	WA
CHC08773-01	Active	BPS-H80-006735	Unity Care Northwest	UCNW Portable Clinical Care	220 Unity St	Bellingham	WA
CHC08773-02	Terminated	BPS-H80-006833	Unity Care Northwest	Point Roberts Clinic	2030 BENSON ROAD	POINT ROBERTS	WA
CHC08773-03	Active	BPS-H80-027565	Unity Care Northwest	UCNW North Whatcom	6060 Portal Way	Ferndale	WA
CHC08773-04	Active	BPS-H80-035486	Unity Care Northwest	UCNW 1616 Cornwall Avenue	1616 Cornwall Ave	Bellingham	WA
CHC08773-05	Terminated	BPS-H80-015335	Unity Care Northwest	UCNW Ferndale Pioneer	5603 Third Avenue	Ferndale	WA
CHC08773-06	Terminated	BPS-H80-030900	Unity Care Northwest	UCNW Respiratory Clinic 1616 #100	1616 Cornwall Ave Ste 100	Bellingham	WA
CHC08773-07	Terminated	BPS-H80-031284	Unity Care Northwest	UCNW NW Respiratory Clinic	6046 Portal Way Ste 202	Ferndale	WA
CHC08773-08	Active	BPS-H80-027564	UNITY CARE NORTHWEST	UCNW Carl Cozier Elementary School	1330 Lincoln St	Bellingham	WA
CHC08773-09	Terminated	BPS-H80-034502	UNITY CARE NORTHWEST	UCNW Bellingham Family Partnership Program	1409 18th St	Bellingham	WA
CHC08773-10	Active	BPS-H80-032966	Unity Care Northwest	UCNW Roosevelt Elementary School	2900 Yew Street, Room 24	Bellingham	WA
CHC08773-11	Active	BPS-H80-012801	UNITY CARE NORTHWEST	UCNW 218 Unity	218 Unity St	Bellingham	WA
CHC08773-12	Active	BPS-H80-038950	UNITY CARE NORTHWEST	UCNW The Way Station	1500 N State St, Ste 101	Bellingham	WA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC08773-04	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	10/01/2017	01/02/2020
CHC08773-04	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	10/01/2017	01/02/2020
CHC08773-00	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	10/01/2022
CHC08773-00	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	10/01/2022
CHC08773-03	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	10/01/2024
CHC08773-09	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	10/01/2024	04/01/2025
CHC08773-11	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	10/01/2024
CHC08773-01	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	10/01/2024
CHC08773-10	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	10/01/2024
CHC08773-04	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	10/01/2024
CHC08773-01	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	10/01/2024
CHC08773-08	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	10/01/2024
CHC08773-03	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	10/01/2024
CHC08773-04	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	10/01/2024
CHC08773-10	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	10/01/2024
CHC08773-11	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	10/01/2024
CHC08773-08	FRED MEYER STORES	800 LAKEWAY DRIVE		BELLINGHAM	WA	98229	10/01/2024
CHC08773-09	FRED MEYER STORES	1225 W. BAKERVIEW ROAD		BELLINGHAM	WA	98226	10/01/2024	04/01/2025
CHC08773-04	GENOA HEALTHCARE LLC	3645 E MCLEOD RD STE P-1		BELLINGHAM	WA	98226	10/01/2022
CHC08773-10	GENOA HEALTHCARE LLC	3645 E MCLEOD RD STE P-1		BELLINGHAM	WA	98226	10/01/2024
CHC08773-09	GENOA HEALTHCARE LLC	3645 E MCLEOD RD STE P-1		BELLINGHAM	WA	98226	10/01/2024	04/01/2025
CHC08773-00	GENOA HEALTHCARE LLC	3645 E MCLEOD RD STE P-1		BELLINGHAM	WA	98226	10/01/2024
CHC08773-11	GENOA HEALTHCARE LLC	3645 E MCLEOD RD STE P-1		BELLINGHAM	WA	98226	10/01/2024
CHC08773-03	GENOA HEALTHCARE LLC	3645 E MCLEOD RD STE P-1		BELLINGHAM	WA	98226	10/01/2024
CHC08773-01	GENOA HEALTHCARE LLC	3645 E MCLEOD RD STE P-1		BELLINGHAM	WA	98226	10/01/2024
CHC08773-08	GENOA HEALTHCARE LLC	3645 E MCLEOD RD STE P-1		BELLINGHAM	WA	98226	10/01/2024
CHC08773-00	HAGGEN		HAGGEN #53 2900 WOBURN	BELLINGHAM	WA	98226	03/08/2010	12/31/2017
CHC08773-00	HAGGEN		HAGGEN FOOD & PHARMACY #163 1815 MAIN STREET	FERNDALE	WA	98248	04/01/2013	12/31/2017
CHC08773-03	HAGGEN		HAGGEN FOOD & PHARMACY #163 1815 MAIN STREET	FERNDALE	WA	98248	03/08/2010	12/31/2017
CHC08773-00	HAGGEN FOODS INC		2814 MERIDIAN STREET	BELLINGHAM	WA	98225	07/02/2010	12/31/2017
CHC08773-04	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/01/2017	01/02/2020
CHC08773-00	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/01/2022
CHC08773-01	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/01/2024
CHC08773-11	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/01/2024
CHC08773-09	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/01/2024	04/01/2025
CHC08773-03	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/01/2024
CHC08773-08	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/01/2024
CHC08773-04	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/01/2024
CHC08773-10	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	10/01/2024
CHC08773-00	HOAGLAND PHARMACY	2330 YEW ST		BELLINGHAM	WA	98229	01/01/2013	01/24/2019
CHC08773-04	HOAGLAND PHARMACY	2330 YEW ST		BELLINGHAM	WA	98229	07/27/2017	01/24/2019
CHC08773-04	SAFEWAY INC	HAGGEN PHARMACY #3430	2814 MERIDIAN ST	BELLINGHAM	WA	98225	07/28/2016	12/31/2017
CHC08773-04	SAFEWAY INC	HAGGEN PHARMACY #3460	2900 WOBURN ST	BELLINGHAM	WA	98226	07/28/2016	12/31/2017
CHC08773-04	SAFEWAY INC	HAGGEN PHARMACY #3493	1815 MAIN ST	FERNDALE	WA	98248	07/28/2016	12/31/2017
CHC08773-04	SAFEWAY INC	SAFEWAY PHARMACY #3285	1275 E SUNSET DRIVE	BELLINGHAM	WA	98226-3506	10/01/2016	12/31/2017
CHC08773-04	SAFEWAY INC	SAFEWAY PHARMACY #1930	8071 GUIDE MERIDIAN ROAD	LYNDEN	WA	98264	10/01/2016	12/31/2017
CHC08773-00	THRIFTY PAYLESS, INC.	RITE AID #5236	1400 CORNWALL AVENUE	BELLINGHAM	WA	98225	01/01/2013	10/05/2023
CHC08773-00	THRIFTY PAYLESS, INC.	RITE AID #5237	3227 NORTHWEST AVENUE	BELLINGHAM	WA	98225	01/01/2013
CHC08773-00	THRIFTY PAYLESS, INC.	RITE AID #5238	220 36TH STREET	BELLINGHAM	WA	98225	01/01/2013
CHC08773-00	THRIFTY PAYLESS, INC.	RITE AID #5239	1225 EAST SUNSET DR STE 110	BELLINGHAM	WA	98226	01/01/2013
CHC08773-00	THRIFTY PAYLESS, INC.	RITE AID #5240	222 TELEGRAPH ROAD	BELLINGHAM	WA	98226	01/01/2013	09/21/2023
CHC08773-00	THRIFTY PAYLESS, INC.	RITE AID #6452	5655 3RD AVE PO BOX 2568	FERNDALE	WA	98248-2568	01/01/2013
CHC08773-04	THRIFTY PAYLESS, INC.	RITE AID #5242	8090 GUIDE MERIDIAN ROAD.	LYNDEN	WA	98264	10/01/2017
CHC08773-04	THRIFTY PAYLESS, INC.	RITE AID #5241	1195 BOBLETT STREET	BLAINE	WA	98230	10/01/2017
CHC08773-04	THRIFTY PAYLESS, INC.	RITE AID #5238	220 36TH STREET	BELLINGHAM	WA	98225	07/27/2017
CHC08773-04	THRIFTY PAYLESS, INC.	RITE AID #5237	3227 NORTHWEST AVENUE	BELLINGHAM	WA	98225	07/27/2017
CHC08773-04	THRIFTY PAYLESS, INC.	RITE AID #5239	1225 EAST SUNSET DR STE 110	BELLINGHAM	WA	98226	07/27/2017
CHC08773-04	THRIFTY PAYLESS, INC.	RITE AID #5236	1400 CORNWALL AVENUE	BELLINGHAM	WA	98225	07/27/2017	10/05/2023
CHC08773-04	THRIFTY PAYLESS, INC.	RITE AID #6452	5655 3RD AVE PO BOX 2568	FERNDALE	WA	98248-2568	07/27/2017
CHC08773-04	THRIFTY PAYLESS, INC.	RITE AID #5240	222 TELEGRAPH ROAD	BELLINGHAM	WA	98226	07/27/2017	09/21/2023
CHC08773-11	THRIFTY PAYLESS, INC.	RITE AID #5242	8090 GUIDE MERIDIAN ROAD.	LYNDEN	WA	98264	10/01/2024
CHC08773-08	THRIFTY PAYLESS, INC.	RITE AID #5237	3227 NORTHWEST AVENUE	BELLINGHAM	WA	98225	10/01/2024
CHC08773-09	THRIFTY PAYLESS, INC.	RITE AID #5241	1195 BOBLETT STREET	BLAINE	WA	98230	10/01/2024	04/01/2025
CHC08773-10	THRIFTY PAYLESS, INC.	RITE AID #5237	3227 NORTHWEST AVENUE	BELLINGHAM	WA	98225	10/01/2024
CHC08773-01	THRIFTY PAYLESS, INC.	RITE AID #6452	5655 3RD AVE PO BOX 2568	FERNDALE	WA	98248-2568	10/01/2024
CHC08773-11	THRIFTY PAYLESS, INC.	RITE AID #5237	3227 NORTHWEST AVENUE	BELLINGHAM	WA	98225	10/01/2024
CHC08773-09	THRIFTY PAYLESS, INC.	RITE AID #6452	5655 3RD AVE PO BOX 2568	FERNDALE	WA	98248-2568	10/01/2024	04/01/2025
CHC08773-10	THRIFTY PAYLESS, INC.	RITE AID #5241	1195 BOBLETT STREET	BLAINE	WA	98230	10/01/2024
CHC08773-09	THRIFTY PAYLESS, INC.	RITE AID #5237	3227 NORTHWEST AVENUE	BELLINGHAM	WA	98225	10/01/2024	04/01/2025
CHC08773-03	THRIFTY PAYLESS, INC.	RITE AID #6452	5655 3RD AVE PO BOX 2568	FERNDALE	WA	98248-2568	10/01/2024
CHC08773-11	THRIFTY PAYLESS, INC.	RITE AID #6452	5655 3RD AVE PO BOX 2568	FERNDALE	WA	98248-2568	10/01/2024
CHC08773-00	THRIFTY PAYLESS, INC.	RITE AID #5241	1195 BOBLETT STREET	BLAINE	WA	98230	10/01/2024
CHC08773-09	THRIFTY PAYLESS, INC.	RITE AID #5242	8090 GUIDE MERIDIAN ROAD.	LYNDEN	WA	98264	10/01/2024	04/01/2025
CHC08773-11	THRIFTY PAYLESS, INC.	RITE AID #5241	1195 BOBLETT STREET	BLAINE	WA	98230	10/01/2024
CHC08773-08	THRIFTY PAYLESS, INC.	RITE AID #6452	5655 3RD AVE PO BOX 2568	FERNDALE	WA	98248-2568	10/01/2024
CHC08773-08	THRIFTY PAYLESS, INC.	RITE AID #5242	8090 GUIDE MERIDIAN ROAD.	LYNDEN	WA	98264	10/01/2024
CHC08773-10	THRIFTY PAYLESS, INC.	RITE AID #5242	8090 GUIDE MERIDIAN ROAD.	LYNDEN	WA	98264	10/01/2024
CHC08773-01	THRIFTY PAYLESS, INC.	RITE AID #5242	8090 GUIDE MERIDIAN ROAD.	LYNDEN	WA	98264	10/01/2024
CHC08773-01	THRIFTY PAYLESS, INC.	RITE AID #5237	3227 NORTHWEST AVENUE	BELLINGHAM	WA	98225	10/01/2024
CHC08773-03	THRIFTY PAYLESS, INC.	RITE AID #5242	8090 GUIDE MERIDIAN ROAD.	LYNDEN	WA	98264	10/01/2024
CHC08773-03	THRIFTY PAYLESS, INC.	RITE AID #5237	3227 NORTHWEST AVENUE	BELLINGHAM	WA	98225	10/01/2024
CHC08773-01	THRIFTY PAYLESS, INC.	RITE AID #5241	1195 BOBLETT STREET	BLAINE	WA	98230	10/01/2024
CHC08773-10	THRIFTY PAYLESS, INC.	RITE AID #6452	5655 3RD AVE PO BOX 2568	FERNDALE	WA	98248-2568	10/01/2024
CHC08773-08	THRIFTY PAYLESS, INC.	RITE AID #5241	1195 BOBLETT STREET	BLAINE	WA	98230	10/01/2024
CHC08773-00	THRIFTY PAYLESS, INC.	RITE AID #5242	8090 GUIDE MERIDIAN ROAD.	LYNDEN	WA	98264	10/01/2024
CHC08773-03	THRIFTY PAYLESS, INC.	RITE AID #5241	1195 BOBLETT STREET	BLAINE	WA	98230	10/01/2024
CHC08773-04	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2022
CHC08773-08	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CHC08773-09	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024	04/01/2025
CHC08773-10	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CHC08773-11	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CHC08773-03	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CHC08773-00	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CHC08773-01	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2024
CHC08773-09	WAL-MART PHARMACY 10-0828	2373 E MAIN STREET		PLAINFIELD	IN	46168	10/01/2024	04/01/2025
CHC08773-04	WAL-MART PHARMACY 10-2450	4420 MERIDIAN STREET		BELLINGHAM	WA	98226	10/01/2022
CHC08773-00	WAL-MART PHARMACY 10-2450	4420 MERIDIAN STREET		BELLINGHAM	WA	98226	10/01/2024
CHC08773-10	WAL-MART PHARMACY 10-2450	4420 MERIDIAN STREET		BELLINGHAM	WA	98226	10/01/2024
CHC08773-11	WAL-MART PHARMACY 10-2450	4420 MERIDIAN STREET		BELLINGHAM	WA	98226	10/01/2024
CHC08773-08	WAL-MART PHARMACY 10-2450	4420 MERIDIAN STREET		BELLINGHAM	WA	98226	10/01/2024
CHC08773-01	WAL-MART PHARMACY 10-2450	4420 MERIDIAN STREET		BELLINGHAM	WA	98226	10/01/2024
CHC08773-09	WAL-MART PHARMACY 10-2450	4420 MERIDIAN STREET		BELLINGHAM	WA	98226	10/01/2024	04/01/2025
CHC08773-03	WAL-MART PHARMACY 10-2450	4420 MERIDIAN STREET		BELLINGHAM	WA	98226	10/01/2024
CHC08773-04	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2022
CHC08773-03	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CHC08773-08	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CHC08773-09	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024	04/01/2025
CHC08773-01	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CHC08773-11	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CHC08773-00	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CHC08773-10	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2024
CHC08773-08	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	10/01/2024
CHC08773-10	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	10/01/2024
CHC08773-09	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	10/01/2024	04/01/2025
CHC08773-11	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	10/01/2024
CHC08773-03	WAL-MART PHARMACY WHSE #45	2250 NORTH 8TH STREET	SUITE 102-A	ROGERS	AR	72756	10/01/2024
CHC08773-04	WALGREEN CO.	DBA: WALGREENS # 05911	4090 GUIDE MERIDIAN RD	BELLINGHAM	WA	98226	01/01/2014
CHC08773-04	WALGREEN CO.	DBA: WALGREENS # 07390	1070 E SUNSET DRIVE	BELLINGHAM	WA	98226-3509	01/01/2014
CHC08773-04	WALGREEN CO.	DBA: WALGREENS # 07782	1901 MAIN ST	FERNDALE	WA	98248-9451	01/01/2014
CHC08773-04	WALGREEN CO.	DBA: WALGREENS #16095	125 SAMISH WAY	BELLINGHAM	WA	98225	10/01/2016
CHC08773-00	WALGREEN CO.	DBA: WALGREENS # 07390	1070 E SUNSET DRIVE	BELLINGHAM	WA	98226-3509	10/01/2024
CHC08773-10	WALGREEN CO.	DBA: WALGREENS # 07782	1901 MAIN ST	FERNDALE	WA	98248-9451	10/01/2024
CHC08773-09	WALGREEN CO.	DBA: WALGREENS # 07782	1901 MAIN ST	FERNDALE	WA	98248-9451	10/01/2024	04/01/2025
CHC08773-11	WALGREEN CO.	DBA: WALGREENS #16095	125 SAMISH WAY	BELLINGHAM	WA	98225	10/01/2024
CHC08773-08	WALGREEN CO.	DBA: WALGREENS # 07782	1901 MAIN ST	FERNDALE	WA	98248-9451	10/01/2024
CHC08773-08	WALGREEN CO.	DBA: WALGREENS # 05911	4090 GUIDE MERIDIAN RD	BELLINGHAM	WA	98226	10/01/2024
CHC08773-08	WALGREEN CO.	DBA: WALGREENS # 07390	1070 E SUNSET DRIVE	BELLINGHAM	WA	98226-3509	10/01/2024
CHC08773-03	WALGREEN CO.	DBA: WALGREENS # 07390	1070 E SUNSET DRIVE	BELLINGHAM	WA	98226-3509	10/01/2024
CHC08773-11	WALGREEN CO.	DBA: WALGREENS # 05911	4090 GUIDE MERIDIAN RD	BELLINGHAM	WA	98226	10/01/2024
CHC08773-10	WALGREEN CO.	DBA: WALGREENS # 07390	1070 E SUNSET DRIVE	BELLINGHAM	WA	98226-3509	10/01/2024
CHC08773-01	WALGREEN CO.	DBA: WALGREENS # 05911	4090 GUIDE MERIDIAN RD	BELLINGHAM	WA	98226	10/01/2024
CHC08773-09	WALGREEN CO.	DBA: WALGREENS # 07390	1070 E SUNSET DRIVE	BELLINGHAM	WA	98226-3509	10/01/2024	04/01/2025
CHC08773-03	WALGREEN CO.	DBA: WALGREENS #16095	125 SAMISH WAY	BELLINGHAM	WA	98225	10/01/2024
CHC08773-03	WALGREEN CO.	DBA: WALGREENS # 05911	4090 GUIDE MERIDIAN RD	BELLINGHAM	WA	98226	10/01/2024
CHC08773-11	WALGREEN CO.	DBA: WALGREENS # 07390	1070 E SUNSET DRIVE	BELLINGHAM	WA	98226-3509	10/01/2024
CHC08773-00	WALGREEN CO.	DBA: WALGREENS #16095	125 SAMISH WAY	BELLINGHAM	WA	98225	10/01/2024
CHC08773-09	WALGREEN CO.	DBA: WALGREENS # 05911	4090 GUIDE MERIDIAN RD	BELLINGHAM	WA	98226	10/01/2024	04/01/2025
CHC08773-00	WALGREEN CO.	DBA: WALGREENS # 07782	1901 MAIN ST	FERNDALE	WA	98248-9451	10/01/2024
CHC08773-10	WALGREEN CO.	DBA: WALGREENS # 05911	4090 GUIDE MERIDIAN RD	BELLINGHAM	WA	98226	10/01/2024
CHC08773-00	WALGREEN CO.	DBA: WALGREENS # 05911	4090 GUIDE MERIDIAN RD	BELLINGHAM	WA	98226	10/01/2024
CHC08773-09	WALGREEN CO.	DBA: WALGREENS #16095	125 SAMISH WAY	BELLINGHAM	WA	98225	10/01/2024	04/01/2025
CHC08773-11	WALGREEN CO.	DBA: WALGREENS # 07782	1901 MAIN ST	FERNDALE	WA	98248-9451	10/01/2024
CHC08773-10	WALGREEN CO.	DBA: WALGREENS #16095	125 SAMISH WAY	BELLINGHAM	WA	98225	10/01/2024
CHC08773-01	WALGREEN CO.	DBA: WALGREENS #16095	125 SAMISH WAY	BELLINGHAM	WA	98225	10/01/2024
CHC08773-08	WALGREEN CO.	DBA: WALGREENS #16095	125 SAMISH WAY	BELLINGHAM	WA	98225	10/01/2024
CHC08773-03	WALGREEN CO.	DBA: WALGREENS # 07782	1901 MAIN ST	FERNDALE	WA	98248-9451	10/01/2024
CHC08773-01	WALGREEN CO.	DBA: WALGREENS # 07782	1901 MAIN ST	FERNDALE	WA	98248-9451	10/01/2024
CHC08773-01	WALGREEN CO.	DBA: WALGREENS # 07390	1070 E SUNSET DRIVE	BELLINGHAM	WA	98226-3509	10/01/2024
CHC08773-04	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	01/01/2014	07/27/2015
CHC08773-04	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CHC08773-00	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CHC08773-01	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2024
CHC08773-04	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CHC08773-01	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CHC08773-10	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CHC08773-00	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CHC08773-03	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CHC08773-08	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024
CHC08773-11	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	1/30/2024 12:00:22 PM	2/27/2025 11:48:16 AM	2/27/2025 11:48 AM
Addresses	Shipping Address	Delete	Change Request	Unity Care Northwest 218 Unity St Bellingham, WA 98225		1/6/2025 1:14 PM
Details	Last Recertification Date	Update	Recertification	1/31/2023 1:22:43 PM	1/30/2024 12:00:22 PM	1/30/2024 12:00 PM
Contacts	Primary Contact	Update	Profile Change Request	Nelson, Lisa Jayne Pharmacy Director Unity Care Northwest 3607882682	Nelson, Lisa Jayne Chief Pharmacy Officer Unity Care Northwest 3607882682	1/16/2024 6:51 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	6/15/2023 4:51 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		2127212	6/15/2023 4:51 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		WA	6/15/2023 4:51 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1376013250	6/15/2023 4:51 PM
Medicaid Billing	NPI: State	Insert	Change Request		WA	6/15/2023 4:51 PM
Details	Last Recertification Date	Update	Recertification	2/21/2022 2:39:50 PM	1/31/2023 1:22:43 PM	1/31/2023 1:22 PM
Contacts	Primary Contact	Update	Change Request	Christie, Callie Pharmacy Compliance Specialist Unity Care Northwest 3605946641	Nelson, Lisa Jayne Pharmacy Director Unity Care Northwest 3607882682	1/26/2023 7:03 PM
Contacts	Authorizing Official	Update	Change Request	Nelson, Lisa Jayne Pharmacy Director Unity Care Northwest 3607882682	Joyce, Jodi Chief Executive Officer Unity Care Northwest 3606766177-1232	1/26/2023 7:03 PM
Details	Last Recertification Date	Update	Recertification	2/22/2021 9:49:18 AM	2/21/2022 2:39:50 PM	2/21/2022 2:39 PM
Addresses	Shipping Address	Delete	Recertification	Unity Care Northwest 218 Unity Street Bellingham, WA 98225		2/22/2021 9:49 AM
Addresses	Shipping Address	Insert	Recertification		Unity Care Northwest 218 Unity St Bellingham, WA 98225	2/22/2021 9:49 AM
Addresses	Main Address	Update	Recertification	6060 Portal Way Ferndale, WA 98248-7833	6060 Portal Way Ferndale, WA 98248	2/22/2021 9:49 AM
Addresses	Billing Address	Update	Recertification	Unity Care Northwest 1616 Cornwall Avenue Suite 205 Bellingham, WA 98225-4642	Unity Care Northwest 1616 Cornwall Ave STE 205 Bellingham, WA 98225	2/22/2021 9:49 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1801359112 ( )		2/22/2021 9:49 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1386089761 ( )		2/22/2021 9:49 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1386089761	2/22/2021 9:49 AM
Medicaid Billing	NPI: State	Insert	Recertification		WA	2/22/2021 9:49 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1801359112	2/22/2021 9:49 AM
Medicaid Billing	NPI: State	Insert	Recertification		WA	2/22/2021 9:49 AM
Details	Last Recertification Date	Update	Recertification	1/31/2020 1:33:59 PM	2/22/2021 9:49:18 AM	2/22/2021 9:49 AM
Contacts	Primary Contact	Update	Recertification	Christie, Callie Pharmacy Compliance Specialist Unity Care Northwest 3606766177-1546	Christie, Callie Pharmacy Compliance Specialist Unity Care Northwest 3605946641	2/17/2021 6:50 PM
Contacts	Primary Contact	Update	Profile Change Request	Christie, Callie Pharmacy Compliance Specialist Unity Care Northwest 3605946641	Christie, Callie Pharmacy Compliance Specialist Unity Care Northwest 3606766177-1546	2/17/2021 6:46 PM
Details	Last Recertification Date	Update	Recertification	2/21/2019 6:12:29 PM	1/31/2020 1:33:59 PM	1/31/2020 1:33 PM
Contacts	Authorizing Official	Update	Change Request	Skubi, Desmond Executive Director Unity Care Northwest 3607882620	Nelson, Lisa Jayne Pharmacy Director Unity Care Northwest 3607882682	1/21/2020 10:31 AM
Contacts	Primary Contact	Update	Change Request	Nelson, Lisa Jayne Pharmacy Director Unity Care Northwest 3607882682	Christie, Callie Pharmacy Compliance Specialist Unity Care Northwest 3605946641	1/21/2020 10:31 AM
Contacts	Primary Contact	Update	Profile Change Request	Nelson, Lisa Jayne Pharmacy Manager Unity Care Northwest 3607882682	Nelson, Lisa Jayne Pharmacy Director Unity Care Northwest 3607882682	1/15/2020 3:56 PM
Addresses	Main Address	Update	Change Request	5616 3RD AVENUE FERNDALE, WA 98248	6060 Portal Way Ferndale, WA 98248-7833	7/5/2019 7:23 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/5/2019 7:23 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		2127891	7/5/2019 7:23 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		WA	7/5/2019 7:23 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1801359112	7/5/2019 7:23 AM
Details	Entity Subname	Update	Change Request	UCNW Ferndale	UCNW North Whatcom	7/5/2019 7:23 AM
Details	Last Recertification Date	Update	Recertification	2/20/2018 4:34:53 PM	2/21/2019 6:12:29 PM	2/21/2019 6:12 PM
Contacts	Primary Contact	Update	Recertification	Nelson, Lisa Pharmacy Manager Unity Care Northwest 3607882682	Nelson, Lisa Jayne Pharmacy Manager Unity Care Northwest 3607882682	2/20/2018 4:34 PM
Details	Last Recertification Date	Update	Recertification	2/7/2017 12:00:00 AM	2/20/2018 4:34:53 PM	2/20/2018 4:34 PM
Contacts	Authorizing Official	Update		Skubi, Desmond Executive Director 3607882620	Skubi, Desmond Executive Director Unity Care Northwest 3607882620	10/2/2017 5:24 PM
Contacts	Primary Contact	Update		Nelson, Lisa Pharmacy Manager 3607882682	Nelson, Lisa Pharmacy Manager Unity Care Northwest 3607882682	10/2/2017 4:27 PM
Contacts	Authorizing Official	Update		SKUBI, DESMOND EXECUTIVE DIRECTOR 3606766177-1104	Skubi, Desmond Executive Director 3607882620	7/27/2017 10:32 AM
Addresses	Main Address	Insert			5616 3RD AVENUE FERNDALE, WA 98248	2/7/2017 7:39 PM
Contacts	Primary Contact	Update		Clarke, Gib Director of Planning and Development 3607882624	Nelson, Lisa Pharmacy Manager 3607882682	2/7/2017 7:39 PM
Details	Last Recertification Date	Update		2/29/2016 12:00:00 AM	2/7/2017 12:00:00 AM	2/7/2017 7:39 PM
Addresses	Billing Address	Insert			Unity Care Northwest 1616 Cornwall Avenue Suite 205 Bellingham, WA 98225-4642	3/15/2016 7:50 AM
Addresses	Shipping Address	Insert			Unity Care Northwest 218 Unity Street Bellingham, WA 98225	3/15/2016 7:50 AM
Details	Entity Name	Update		INTERFAITH COMMUNITY HEALTH CENTER	Unity Care Northwest	3/15/2016 7:49 AM
Details	Entity Subname	Update		ICHC- Ferndale	UCNW Ferndale	3/15/2016 7:49 AM
Details	Last Recertification Date	Update		2/12/2015 12:00:00 AM	2/29/2016 12:00:00 AM	2/29/2016 2:01 PM
Contacts	Primary Contact	Update		Clarke, Gib Director of Planning and Development 3606766177-1622	Clarke, Gib Director of Planning and Development 3607882624	12/16/2015 12:29 PM
Details	Last Recertification Date	Update		2/24/2014 12:00:00 AM	2/12/2015 12:00:00 AM	2/12/2015 1:02 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/24/2014 12:00:00 AM	2/24/2014 4:41 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	1/27/2014 5:32 PM
Medicaid Billing	Medicaid: Number	Insert			2030572	1/27/2014 5:32 PM
Medicaid Billing	Medicaid: State	Insert			WA	1/27/2014 5:32 PM
Medicaid Billing	NPI: Number	Insert			1386089761	1/27/2014 5:32 PM
Details	Entity Subname	Update			ICHC- Ferndale	1/27/2014 5:32 PM
Contacts	Primary Contact	Update		SKUBI, DESMOND EXECUTIVE DIRECTOR 3606766177-1104	Clarke, Gib Director of Planning and Development 3606766177-1622	9/4/2013 3:32 PM
Contacts	Authorizing Official	Insert			SKUBI, DESMOND EXECUTIVE DIRECTOR 3606766177-1104	2/7/2013 10:41 AM
Contacts	Primary Contact	Insert			SKUBI, DESMOND EXECUTIVE DIRECTOR 3606766177-1104	2/7/2013 10:41 AM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/7/2013 10:41 AM
Details	Last Recertification Date	Insert				12/21/2009 6:49 PM
Details	Grant Number	Insert			H80CS08773	12/21/2009 6:49 PM
Details	340B ID	Insert			CHC08773-03	12/21/2009 6:49 PM
Details	Is Authorizing Official EHB Data	Insert				12/21/2009 6:49 PM
Dates	Last Date That 340B Drugs Purchased	Insert				12/21/2009 6:49 PM
Details	Medicare Provider Number	Insert				12/21/2009 6:49 PM
Details	Entity Name	Insert			INTERFAITH COMMUNITY HEALTH CENTER	12/21/2009 6:49 PM
Details	Program Code	Insert			CH	12/21/2009 6:49 PM
Details	Entity Subname	Insert				12/21/2009 6:49 PM
Dates	Participating Approval Date	Insert			12/21/2009 12:00:00 AM	12/21/2009 6:49 PM
Details	State	Insert			Active	12/21/2009 6:49 PM
Dates	Registration Date	Insert			12/10/2009 12:00:00 AM	12/21/2009 6:49 PM
Dates	Signed By Date	Insert			11/19/2009 12:00:00 AM	12/21/2009 6:49 PM
Dates	Start Date	Insert			1/1/2010 12:00:00 AM	12/21/2009 6:49 PM
Terminations	Termination Comments	Insert				12/21/2009 6:49 PM
Terminations	Termination Date	Insert				12/21/2009 6:49 PM
Terminations	Termination Effective Date	Insert				12/21/2009 6:49 PM
Terminations	Termination Reason	Insert				12/21/2009 6:49 PM

340B Drug Pricing Program Database