340B Drug Pricing Program Database
TARGET STORES A DIV.OF TARGET CORP.
PED503301-00 Mary Bridge Children's Hospital and Health Center - information as of 4/25/2025 7:13:34 PM
Covered Entity Details
Entity Name
Mary Bridge Children's Hospital and Health Center
Subdivision Name
Type
Children's Hospital
340B ID
PED503301-00
Entity Address
317 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Medicare Provider Number
503301
Participating Start Date
10/1/2011
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
TARGET STORES A DIV.OF TARGET CORP.
Pharmacy Address
TARGET STORE T-1205
ATTN: PHARMACY
11400-51 ST AVENUE
GIG HARBOR, WA 98332
Pharmacy Comments
Contract Details
Approval Date
10/11/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Florence Chang, President
(253) 403-7355
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/11/2020
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