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CH10253J International Community Health Services (Active)
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Main Details
Name
International Community Health Services
Subdivision Name
ICHS Mobile Dental Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019301
340B ID
CH10253J
Grant Number
H80CS00437
Additional Details
Current Program Status
Active
Registration Date
7/9/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/11/2019
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
ICHS
Kelli Nomura, CEO
(206) 788-3659
Primary Contact
ICHS
Ju Hui Lee, Pharmacy Director
(206) 788-3756
Addresses
Street Address
720 8th Avenue South
Seattle, WA 98104-3032
Billing Address
International Community Health Services
PO BOX 3007
Seattle, WA 98114
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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