Pharmacy Details

CUSTOM PRESCRIPTION SHOPPE - information as of 5/9/2025 12:31:04 AM

Name
CUSTOM PRESCRIPTION SHOPPE

Address

5917 PORTAL WAY
FERNDALE, WA 98248

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	CH100570	COLUMBIA VALLEY COMMUNITY HEALTH	CVCH Wenatchee Clinic	HRSA-Funded Health Center	600 Orondo Ave STE 1		Wenatchee	WA	01/01/2019	09/02/2020	9/2/2020 6:44 PM
Details	CH101020	Sea Mar Community Health Centers	Sea Mar CHC - Administration	HRSA-Funded Health Center	1040 S. Henderson St.		Seattle	WA	04/01/2019	07/15/2024	7/15/2024 4:57 PM
Details	CH10102A	Sea Mar Community Health Centers	Sea Mar CHC - Mt. Vernon N. LaVenture Rd.	HRSA-Funded Health Center	1400 N LAVENTURE RD		MOUNT VERNON	WA	03/08/2010	07/15/2024	7/15/2024 4:57 PM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			CUSTOM PRESCRIPTION SHOPPE 5917 PORTAL WAY FERNDALE, WA 98248	3/1/2018 12:11 PM
Addresses	Pharmacy Address	Insert			CUSTOM PRESCRIPTION SHOPPE 1313 EAST MAPLE STREET SUITE 101 BELLINGHAM, WA 98225	9/29/2017 6:44 AM
Addresses	Pharmacy Address	Update		CUSTOM PRESCRIPTION SHOPPE 1313 E MAPLE STREET BELLINGHAM, WA 98225	CUSTOM PRESCRIPTION SHOPPE 1313 EAST MAPLE STREET SUITE 101 BELLINGHAM, WA 98225	7/29/2015 9:04 AM
Details	Comments	Update				3/28/2013 4:35 PM
Addresses	Pharmacy Address	Update		CUSTOM RX SHOPPE 1313 EAST MAPLE ST., SUITE 101 BELLINGHAM, WA 98225	CUSTOM PRESCRIPTION SHOPPE 1313 E MAPLE STREET BELLINGHAM, WA 98225	3/28/2013 4:35 PM
Details	Name	Update		CUSTOM RX SHOPPE	CUSTOM PRESCRIPTION SHOPPE	3/28/2013 4:35 PM
Details	Comments	Insert				8/5/2010 4:10 PM
Details	Is Deleted	Insert			False	8/5/2010 4:10 PM
Addresses	Pharmacy Address	Insert			CUSTOM RX SHOPPE 1313 EAST MAPLE ST., SUITE 101 BELLINGHAM, WA 98225	8/5/2010 4:10 PM
Details	Name	Insert			CUSTOM RX SHOPPE	8/5/2010 4:10 PM