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BARTELL DRUGS #06936
CH102520 Seattle Roots Community Health
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Covered Entity Details
Entity Name
Seattle Roots Community Health
Subdivision Name
Seattle Roots at Country Doctor
Type
HRSA-Funded Health Center
340B ID
CH102520
Entity Address
500 19th Ave E
Seattle, WA 98112-4007
Grant Number
H80CS00647
Participating Start Date
1/1/1998
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
BARTELL DRUGS #06936
Pharmacy Address
1001 MERCER ST
SEATTLE, WA 98109-4324
Pharmacy Comments
Contract Details
Approval Date
4/9/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/3/2019
Agreement registered in error
Contacts
Covered Entity Signing Official
Raleigh R Watts, Executive Director
(206) 299-1628
Contract Pharmacy Representative
Bartell Drugs
Marla Gunn, District Manager
(206) 767-1351
Signed By Date
4/9/2019
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