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JIM'S PHARMACY
FQHC638398 JAMESTOWN S'KLALLAM TRIBE
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Covered Entity Details
Entity Name
JAMESTOWN S'KLALLAM TRIBE
Subdivision Name
Jamestown Family Health Clinic
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638398
Entity Address
808 N. 5th Avenue
SEQUIM, WA 98382
Grant Number
Participating Start Date
1/1/2001
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
JIM'S PHARMACY
Pharmacy Address
424 E 2ND ST
CAMMACK'S PHARMACIES INC
PORT ANGELES, WA 98362-3119
Pharmacy Comments
Contract Details
Approval Date
1/23/2006
Contract Begin Date
1/23/2006
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ron W. Allen, CEO
(360) 683-1109
Contract Pharmacy Representative
JOE CAMMACK, OWNER
(360) 452-4200
Signed By Date
1/20/2006
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