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HEALTHY OPTIONS INC
DSH500003 SKAGIT VALLEY HOSPITAL
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Covered Entity Details
Entity Name
SKAGIT VALLEY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500003
Entity Address
1415 EAST KINCAID
MOUNT VERNON, WA 98274-4126
Medicare Provider Number
500003
Participating Start Date
7/1/2006
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
HEALTHY OPTIONS INC
Pharmacy Address
DBA POSTAL PRESCRIPTION SVCS
3500 SE 26TH AVE
PO BOX 2718
PORTLAND, OR 97202
Pharmacy Comments
Contract Details
Approval Date
10/25/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Ishizuka, CFO
(360) 814-5838
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/25/2018
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