Contract Pharmacy Details

PUBLIC HEALTH
STD98122 Planned Parenthood Great Northwest, Hawai‘i, Alaska, Indiana, Kentucky

Covered Entity Details

Entity Name

Planned Parenthood Great Northwest, Hawai‘i, Alaska, Indiana, Kentucky

Subdivision Name

Central District Health Center

Type

Sexually Transmitted Diseases

340B ID

STD98122

Entity Address

2001 East Madison Street
Seattle, WA 98122

Grant Number

NH25PS005146

Participating Start Date

1/1/2005

Last Recertification Date

5/31/2024

Pharmacy Details

Pharmacy Name

PUBLIC HEALTH

Pharmacy Address

DOWNTOWN CENTRAL PHARMACY
2124 4TH AVE
SEATTLE, WA 98121

Pharmacy Comments

Contract Details

Approval Date

1/30/2012

Contract Begin Date

1/30/2012

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

MARK AUBIN, DIRECTOR - STD SERVICES
(360) 236-3467

Contract Pharmacy Representative

Benjamin Leifer, Chief Administrative Officer
(206) 263-8696

Signed By Date

12/9/2011

340B Drug Pricing Program Database