Contract Pharmacy Details

KVH INC.
FQHC638487A SNOQUALMIE INDIAN TRIBE

Covered Entity Details

Entity Name

SNOQUALMIE INDIAN TRIBE

Subdivision Name

NORTH BEND FAMILY CLINIC

Type

Tribal Contract/Compact with IHS (P.L. 93-638)

340B ID

FQHC638487A

Entity Address

404 MAIN AVENUE S
NORTH BEND, WA 98045

Grant Number

Participating Start Date

7/1/2005

Last Recertification Date

2/23/2017

Entity Termination Date

4/1/2017

Pharmacy Details

Pharmacy Name

KVH INC.

Pharmacy Address

DBA DUVALL FAMILY DRUGS
15602 MAIN ST NE
DUVALL, WA 98019-8578

Pharmacy Comments

Contract Details

Approval Date

12/22/2008

Contract Begin Date

12/22/2008

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2017

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

12/2/2008

340B Drug Pricing Program Database