340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WASHINGTON CVS PHARMACY, L.L.C.
PED503301-00 Mary Bridge Children's Hospital and Health Center
Print
Covered Entity Details
Entity Name
Mary Bridge Children's Hospital and Health Center
Subdivision Name
Type
Children's Hospital
340B ID
PED503301-00
Entity Address
317 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Medicare Provider Number
503301
Participating Start Date
10/1/2011
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
WASHINGTON CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 16123
3320 S 23RD ST
TACOMA, WA 98405
Pharmacy Comments
Contract Details
Approval Date
4/17/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Florence Chang, President
(253) 403-7355
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/17/2020
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