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WALLACE DRUG
CH10018D HEALTH WEST, INC.
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Covered Entity Details
Entity Name
HEALTH WEST, INC.
Subdivision Name
HEALTH WEST- ABERDEEN CHC
Type
HRSA-Funded Health Center
340B ID
CH10018D
Entity Address
330 N Main Street
ABERDEEN, ID 83210
Grant Number
H80CS00321
Participating Start Date
4/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALLACE DRUG
Pharmacy Address
44 S MAIN ST.
BOX 841
ABERDEEN, ID 83210
Pharmacy Comments
Contract Details
Approval Date
4/1/2004
Contract Begin Date
4/1/2004
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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