340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PREMIER LONG TERM CARE PHARMACY
CH10102M Sea Mar Community Health Centers
Print
Covered Entity Details
Entity Name
Sea Mar Community Health Centers
Subdivision Name
Sea Mar CHC - Seattle 8720 14th Ave. S.
Type
HRSA-Funded Health Center
340B ID
CH10102M
Entity Address
8720 14th Ave S
Seattle, WA 98108
Grant Number
H80CS00445
Participating Start Date
10/1/2001
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
PREMIER LONG TERM CARE PHARMACY
Pharmacy Address
1618 SOUTH LANE SUITE 204
SEATTLE, WA 98144
Pharmacy Comments
Contract Details
Approval Date
6/8/2012
Contract Begin Date
6/8/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mary Bartolo, VP, Deputy Director
(206) 763-5277
Contract Pharmacy Representative
Ponce Bautista, Vice President Operations/Owner
(206) 323-0868
Signed By Date
6/7/2012
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