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HARBOR DRUG INC
SCH500031-00 Grays Harbor Community Hospital
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Covered Entity Details
Entity Name
Grays Harbor Community Hospital
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH500031-00
Entity Address
915 Anderson Drive
Aberdeen, WA 98520
Medicare Provider Number
500031
Participating Start Date
10/1/2012
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
HARBOR DRUG INC
Pharmacy Address
316 8TH ST
HOQUIAM, WA 98550
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Niall Foley, Chief Financial Officer
(360) 537-5145
Contract Pharmacy Representative
Peninsula Pharmacies Inc.
JEFF HARRELL, PRESIDENT
(360) 642-3200
Signed By Date
1/15/2021
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