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FRED MEYER STORES
CH10257B COMMUNITY HEALTH ASSOCIATION OF SPOKANE
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Covered Entity Details
Entity Name
COMMUNITY HEALTH ASSOCIATION OF SPOKANE
Subdivision Name
Valley Clinic
Type
HRSA-Funded Health Center
340B ID
CH10257B
Entity Address
15812 E Indiana Ave
Spokane Valley, WA 99216
Grant Number
H80CS00319
Participating Start Date
1/1/2001
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
FRED MEYER STORES
Pharmacy Address
400 SOUTH THOR ST
SPOKANE, WA 99202-5075
Pharmacy Comments
Contract Details
Approval Date
7/18/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aaron Wilson, CEO
(509) 444-8888
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
7/18/2016
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