Covered Entity Details

CH10064BB NEIGHBORCARE HEALTH (Terminated) - information as of 5/24/2025 12:47:58 AM

Main Details

Name

NEIGHBORCARE HEALTH

Subdivision Name

Garfield High School

Type

HRSA-Funded Health Center

Site ID

BPS-H80-016970

340B ID

CH10064BB

Grant Number

H80CS00829

Additional Details

Current Program Status

Terminated

Registration Date

4/1/2016

Participating Start Date

7/1/2016

Participating Approval Date

4/12/2016

Last Recertification Date

2/14/2019

Termination Date
Termination Reason

4/1/2020
Never implemented the 340B Program

Contacts

Authorizing Official

Neighborcare Health
Michael Erikson, Chief Executive Officer
(206) 548-3050

Primary Contact

Neighborcare Health
Kara Styles, Grant Specialist
(206) 548-7540

Addresses

Street Address

400 23RD AVE
SEATTLE, WA 98122

Billing Address

Neighborcare Health
1200 12th Ave S
Suite 901
Seattle, WA 98144

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	2023770
		1104161496

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	Address Cont.	City	State
CH100640	Active	BPS-H80-014734	NEIGHBORCARE HEALTH	Neighborcare Health Administration	1200 12th AVE S,	Suite 901	Seattle	WA
CH10064A	Active	BPS-H80-003417	NEIGHBORCARE HEALTH	Neighborcare Health at High Point	6020 35th Ave SW		Seattle	WA
CH10064AB	Active	BPS-H80-001088	NEIGHBORCARE HEALTH	Neighborcare Health at 45th Street- Medical	1629 N 45th St		Seattle	WA
CH10064AD	Active	BPS-H80-000348	NEIGHBORCARE HEALTH	Neighborcare Health at Madison Middle School	3429 45th Ave SW		Seattle	WA
CH10064AF	Active	BPS-H80-000774	NEIGHBORCARE HEALTH	Neighborcare Health at West Seattle High School	3000 CALIFORNIA AVE SW		SEATTLE	WA
CH10064AH	Active	BPS-H80-001300	NEIGHBORCARE HEALTH	Neighborcare Health at Pike Place Market	1930 POST ALY		SEATTLE	WA
CH10064AJ	Terminated	BPS-H80-009423	NEIGHBORCARE HEALTH	McDermott Place Medical Clinic	12736 33rd Ave NE		Seattle	WA
CH10064AK	Terminated	BPS-H80-011060	NEIGHBORCARE HEALTH	Neighborcare Health at Mercer Middle School	1600 S. Columbian Way		Seattle	WA
CH10064AL	Active	BPS-H80-012657	NEIGHBORCARE HEALTH	Neighborcare Health at Lake City	12721 30th Ave NE		Seattle	WA
CH10064AM	Active	BPS-H80-013583	NEIGHBORCARE HEALTH	Neighborcare Health at Dearborn Park International School	2820 S Orcas St		Seattle	WA
CH10064AP	Terminated	BPS-H80-012708	NEIGHBORCARE HEALTH	Neighborcare Health at Roxhill Elementary	9430 30th Ave SW		Seattle	WA
CH10064AQ	Active	BPS-H80-012715	NEIGHBORCARE HEALTH	Neighborcare Health at Highland Park Elementary	1012 SW Trenton St.		Seattle	WA
CH10064AR	Active	BPS-H80-014270	NEIGHBORCARE HEALTH	Neighborcare Health Ballard Homeless Clinic at Nyer Urness House	1753 NW 56th Street	Suite 200	Seattle	WA
CH10064AS	Active	BPS-H80-013853	NEIGHBORCARE HEALTH	Neighborcare Health at Bailey Gatzert Elementary	1301 E Yesler Way		Seattle	WA
CH10064AT	Active	BPS-H80-014066	NEIGHBORCARE HEALTH	Neighborcare Health at West Seattle Elementary	6760 34th Ave SW		Seattle	WA
CH10064AU	Active	BPS-H80-014134	NEIGHBORCARE HEALTH	Neighborcare Health at Rising Star Elementary	8311 Beacon Ave S		Seattle	WA
CH10064AV	Terminated	BPS-H80-014269	NEIGHBORCARE HEALTH	Beacon Hill International School	2025 14TH AVE S		SEATTLE	WA
CH10064AW	Terminated	BPS-H80-009946	NEIGHBORCARE HEALTH	Seattle World School Wellness Center	301 21st Ave E		Seattle	WA
CH10064AX	Terminated	BPS-H80-014065	NEIGHBORCARE HEALTH	Neighborcare Health at St. Vincent de Paul - Aurora	13555 AURORA AVE N		SEATTLE	WA
CH10064AY	Terminated	BPS-H80-009620	NEIGHBORCARE HEALTH	Hamilton International Middle School Wellness Center	1610 N 41st St		Seattle	WA
CH10064AZ	Terminated	BPS-H80-014410	NEIGHBORCARE HEALTH	Neighborcare Health at Meridian	10501 MERIDIAN AVE N		SEATTLE	WA
CH10064BA	Active	BPS-H80-014586	NEIGHBORCARE HEALTH	Meridian Center for Health	10521 MERIDIAN AVE N		SEATTLE	WA
CH10064BB	Terminated	BPS-H80-016970	NEIGHBORCARE HEALTH	Garfield High School	400 23RD AVE		SEATTLE	WA
CH10064BC	Terminated	BPS-H80-018795	NEIGHBORCARE HEALTH	Neighborcare Health at Vashon	10030 SW 210TH ST		VASHON	WA
CH10064BD	Active	BPS-H80-001805	NEIGHBORCARE HEALTH	Neighborcare Health at Georgetown	6200 13th Ave S		Seattle	WA
CH10064BE	Active	BPS-H80-001537	NEIGHBORCARE HEALTH	Neighborcare Health at 45th Street - Dental	1629 N 45TH ST		SEATTLE	WA
CH10064BF	Active	BPS-H80-018185	NEIGHBORCARE HEALTH	Neighborcare Health at Pacific Tower	1200 12th Avenue South, Suite #401		Seattle	WA
CH10064BG	Terminated	BPS-H80-006267	NEIGHBORCARE HEALTH	Neighborcare Health at Central District	2101 EAST YESLER WAY STE 300		SEATTLE	WA
CH10064BH	Active	BPS-H80-019107	NEIGHBORCARE HEALTH	The Morrison	509 3rd Avenue		Seattle	WA
CH10064BJ	Active	BPS-H80-020840	NEIGHBORCARE HEALTH	Simons Senior Apartments	2119 3rd Ave., #428		Seattle	WA
CH10064BK	Terminated	BPS-H80-014202	NEIGHBORCARE HEALTH	Madrona K-8 School-Based Health Center	1121 33rd Ave		Seattle	WA
CH10064BL	Active	BPS-H80-032965	NEIGHBORCARE HEALTH	Neighborcare Health at Vashon High School	9600 SW 204th St., Room 1205		Vashon	WA
CH10064BM	Active	BPS-H80-024585	Neighborcare Health	Neighborcare Health at Roxhill Elementary	7740 34th Ave SW		Seattle	WA
CH10064BN	Active	BPS-H80-024736	Neighborcare Health	New Horizons	2709 3rd Ave		Seattle	WA
CH10064BP	Active	BPS-H80-028335	Neighborcare Health	Neighborcare Health at Lincoln High School	4400 Interlake Ave N Rm 132		Seattle	WA
CH10064BQ	Active	BPS-H80-027831	Neighborcare Health	Neighborcare Health at Magnuson	7101 62nd Ave NE Ste 4		Seattle	WA
CH10064BR	Active	BPS-H80-028336	Neighborcare Health	Neighborcare Health at Robert Eagle Staff Middle School	1330 N 90th St Rm M111		Seattle	WA
CH10064BS	Terminated	BPS-H80-029705	Neighborcare Health	Neighborcare Health Dental at Providence St. Peter Hospital	525 Lilly Rd NE Ste 110		Olympia	WA
CH10064BU	Terminated	BPS-H80-033032	Neighborcare Health	Neighborcare Health at West Seattle Elementary School (Temporary)	5000 SW Spokane St Trlr # 17		Seattle	WA
CH10064BV	Active	BPS-H80-037507	Neighborcare Health	Neighborcare Health at Mercer Middle School	7201 Beacon Ave S		Seattle	WA
CH10064BW	Active	BPS-H80-037504	Neighborcare Health	Neighborcare Health at Denny International Middle School	2601 SW Kenyon Street		Seattle	WA
CH10064F	Active	BPS-H80-004116	NEIGHBORCARE HEALTH	Neighborcare Health at Columbia City	4400 37th Ave S		Seattle	WA
CH10064I	Active	BPS-H80-000674	NEIGHBORCARE HEALTH	Neighborcare Health at Chief Sealth International High School	2600 SW Thistle St		Seattle	WA
CH10064J	Terminated	BPS-H80-012277	NEIGHBORCARE HEALTH	Neighborcare Health at Denny International Middle School	2601 SW Kenyon Street		Seattle	WA
CH10064L	Active	BPS-H80-010447	NEIGHBORCARE HEALTH	Neighborcare Health at Rainier Beach	9245 Rainier Ave S		Seattle	WA
CH10064N	Active	BPS-H80-001051	NEIGHBORCARE HEALTH	Neighborcare Health at Roosevelt High School	1410 NE 66th St.		SEATTLE	WA
CH10064P	Terminated	BPS-H80-001050	NEIGHBORCARE HEALTH	GREENWOOD MEDICAL CLINIC	415 N 85th St		Seattle	WA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH100640	GENOA HEALTHCARE LLC	2704 I STREET NE		AUBURN	WA	98002	04/01/2025
CH100640	GENOA HEALTHCARE LLC	3639 MARTIN LUTHER KING JR. WAY S, STE P		SEATTLE	WA	98144	04/01/2025
CH100640	GENOA HEALTHCARE LLC	11000 LAKE CITY WAY NE STE 421		SEATTLE	WA	98125	04/01/2025
CH100640	GENOA HEALTHCARE LLC	1600 EAST OLIVE STREET	BLDG D	SEATTLE	WA	98122	04/01/2025
CH100640	GENOA HEALTHCARE LLC	5455 ALMIRA DRIVE NE	STE 329	BREMERTON	WA	98311	04/01/2025
CH100640	GENOA HEALTHCARE LLC	325 W. GOWE STREET	SUITE 110	KENT	WA	98032	04/01/2025
CH100640	GENOA HEALTHCARE LLC	4508 AUBURN WAY N	STE A104	AUBURN	WA	98002	04/01/2025
CH100640	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	04/01/2025
CH100640	OPTUM PHARMACY 701, LLC	8131 W BOSTIAN RD STE A350		WOODINVILLE	WA	98072-5029	04/01/2025
CH100640	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	04/01/2025
CH100640	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	04/01/2025
CH100640	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	04/01/2025
CH100640	OTHELLO STATION PHARMACY	SALAAM HEALTH PLLC	4219 S OTHELLO ST # 105F	SEATTLE	WA	98118-3892	07/01/2023
CH100640	WALGREEN CO.	DBA: WALGREENS # 03604	5409 15TH AVENUE NW	SEATTLE	WA	98107	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 03632	2400 S. JACKSON ST.	SEATTLE	WA	98144	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 03788	14510 AURORA AVE N	SHORELINE	WA	98133-6525	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 03840	14656 AMBAUM BLVD SW	BURIEN	WA	98166	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 04157	859 NE NORTHGATE WAY	SEATTLE	WA	98125	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 04627	275 RAINIER AVENUE S	RENTON	WA	98057	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 04898	6330 35TH AVE. SW	SEATTLE	WA	98126	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 05950	4412 RAINIER AVE S	SEATTLE	WA	98118	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 06194	222 PIKE STREET	SEATTLE	WA	98101-3635	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 06259	9456 16TH AVE SW	SEATTLE	WA	98106-2824	07/01/2013
CH100640	WALGREEN CO.	DBA: WALGREENS # 03515	8701 GREENWOOD AVE N	SEATTLE	WA	98103	10/01/2013	04/05/2017
CH10064A	WALGREEN CO.	DBA: WALGREENS # 04898	6330 35TH AVE. SW	SEATTLE	WA	98126	06/15/2006	03/06/2023
CH100640	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	07/01/2013	07/21/2015
CH100640	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/01/2013	07/21/2015
CH100640	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	01/01/2025
CH100640	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	01/01/2025
CH100640	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	01/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	4/1/2020 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		4/1/2020 12:00:00 AM	2/24/2020 8:09 AM
Details	State	Update	Recertification	Active	To Be Terminated	2/24/2020 8:09 AM
Terminations	Termination Comments	Update	Recertification		This was a dental only school site that never accessed 340b drugs.	2/24/2020 8:09 AM
Terminations	Termination Date	Update	Recertification		4/1/2020 12:00:00 AM	2/24/2020 8:09 AM
Terminations	Termination Effective Date	Update	Recertification		4/1/2020 12:00:00 AM	2/24/2020 8:09 AM
Terminations	Termination Reason	Update	Recertification		Never implemented the 340B Program	2/24/2020 8:09 AM
Details	Last Recertification Date	Update	Recertification	3/6/2018 5:41:56 PM	2/14/2019 4:58:05 PM	2/14/2019 4:58 PM
Contacts	Primary Contact	Update	Change Request	Amberson, Susan Director of Grants & Compliance Neighborcare Health 2065483265	Styles, Kara Grant Specialist Neighborcare Health 2065487540	1/25/2019 2:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	6032171 (WA)		3/6/2018 5:41 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	3/6/2018 5:41 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		2023770	3/6/2018 5:41 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		WA	3/6/2018 5:41 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1063653566 ( )		3/6/2018 5:41 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1104161496	3/6/2018 5:41 PM
Details	Last Recertification Date	Update	Recertification	2/16/2017 12:00:00 AM	3/6/2018 5:41:56 PM	3/6/2018 5:41 PM
Details	Is Authorizing Official EHB Data	Update	Recertification	False		3/6/2018 5:41 PM
Contacts	Authorizing Official	Update		Erikson, Michael Chief Executive Officer 2065483050	Erikson, Michael Chief Executive Officer Neighborcare Health 2065483050	10/12/2017 5:55 PM
Contacts	Signed By	Update		Erikson, Michael Chief Executive Officer 2065483050	Erikson, Michael Chief Executive Officer Neighborcare Health 2065483050	10/12/2017 5:55 PM
Contacts	Primary Contact	Update		Amberson, Susan Director of Grants & Compliance 2065483265	Amberson, Susan Director of Grants & Compliance Neighborcare Health 2065483265	10/10/2017 5:29 PM
Contacts	Authorizing Official	Insert			Erikson, Michael Chief Executive Officer 2065483050	5/1/2017 6:05 PM
Contacts	Signed By	Insert			Erikson, Michael Chief Executive Officer 2065483050	5/1/2017 6:05 PM
Contacts	Primary Contact	Update		LOLAGI, SHANDI EXECUTIVE ASSISTANT 2065483005	Amberson, Susan Director of Grants & Compliance 2065483265	5/1/2017 6:05 PM
Addresses	Main Address	Insert			400 23RD AVE SEATTLE, WA 98122	2/17/2017 5:37 PM
Details	Last Recertification Date	Update			2/16/2017 12:00:00 AM	2/17/2017 5:37 PM
Contacts	Primary Contact	Insert			LOLAGI, SHANDI EXECUTIVE ASSISTANT 2065483005	1/6/2017 8:55 AM
Addresses	Billing Address	Insert			Neighborcare Health 1200 12th Ave S Suite 901 Seattle, WA 98144	4/12/2016 10:58 AM
Dates	Participating Approval Date	Update			4/12/2016 12:00:00 AM	4/12/2016 10:58 AM
Details	State	Update		Pending	Active	4/12/2016 10:58 AM
Dates	Start Date	Update			7/1/2016 12:00:00 AM	4/12/2016 10:58 AM
Details	340B ID	Update		ONLINE_REG_58700	CH10064BB	4/8/2016 1:49 PM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_58700	4/1/2016 10:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	4/1/2016 10:59 AM
Medicaid Billing	Medicaid: Number	Insert			6032171	4/1/2016 10:59 AM
Medicaid Billing	Medicaid: State	Insert			WA	4/1/2016 10:59 AM
Medicaid Billing	NPI: Number	Insert			1063653566	4/1/2016 10:59 AM
Details	Last Recertification Date	Insert				4/1/2016 10:59 AM
Details	Grant Number	Insert			H80CS00829	4/1/2016 10:59 AM
Details	340B ID	Insert			ONLINE_REG	4/1/2016 10:59 AM
Details	Is Authorizing Official EHB Data	Insert			False	4/1/2016 10:59 AM
Dates	Last Date That 340B Drugs Purchased	Insert				4/1/2016 10:59 AM
Details	Medicare Provider Number	Insert				4/1/2016 10:59 AM
Details	Entity Name	Insert			NEIGHBORCARE HEALTH	4/1/2016 10:59 AM
Details	Program Code	Insert			CH	4/1/2016 10:59 AM
Details	Entity Subname	Insert			Garfield High School	4/1/2016 10:59 AM
Dates	Participating Approval Date	Insert				4/1/2016 10:59 AM
Details	State	Insert			Pending	4/1/2016 10:59 AM
Dates	Registration Date	Insert			4/1/2016 12:00:00 AM	4/1/2016 10:59 AM
Dates	Signed By Date	Insert			4/1/2016 12:00:00 AM	4/1/2016 10:59 AM
Dates	Start Date	Insert				4/1/2016 10:59 AM
Terminations	Termination Comments	Insert				4/1/2016 10:59 AM
Terminations	Termination Date	Insert				4/1/2016 10:59 AM
Terminations	Termination Effective Date	Insert				4/1/2016 10:59 AM
Terminations	Termination Reason	Insert				4/1/2016 10:59 AM

340B Drug Pricing Program Database