340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
QFC
FQHC638398 JAMESTOWN S'KLALLAM TRIBE
Print
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
QFC
Pharmacy Address
DBA PORT HADLOCK PHARMACY
1890 IRONDALE ROAD
PO BOX 149
PORT HADLOCK, WA 98339
Pharmacy Comments
1/18/2012 updated name (was QFC Pharmacy #495)
Contract Details
Approval Date
4/4/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/3/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brent D. Simcosky, Director of Health Services
(360) 582-4870
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
4/4/2013
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session