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VALLEY DRUG CO.
FQHC638341 CAMAS CENTER FOR COMMUNITY WELLNESS MEDICAL SERVICES DEPARTMENT
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Covered Entity Details
Entity Name
CAMAS CENTER FOR COMMUNITY WELLNESS MEDICAL SERVICES DEPARTMENT
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638341
Entity Address
1821 LECLERC RD. #1
CUSICK, WA 99119
Grant Number
Participating Start Date
7/1/2018
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
VALLEY DRUG CO.
Pharmacy Address
E. 102 MAIN
P.O. BOX 107
CHEWELAH, WA 99109-0107
Pharmacy Comments
Contract Details
Approval Date
5/8/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jessica Pakootas, Executive Director
(509) 447-7442
Contract Pharmacy Representative
Valley Drug Co.
Dustin Person, Pharmacist
(509) 671-2242
Signed By Date
5/4/2018
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