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GRUBBS CARE PHARMACY NW INC.
CHC22679-02 ELAINE ELLIS CENTER OF HEALTH, INC.
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Covered Entity Details
Entity Name
ELAINE ELLIS CENTER OF HEALTH, INC.
Subdivision Name
Kenilworth
Type
HRSA-Funded Health Center
340B ID
CHC22679-02
Entity Address
1627 Kenilworth Ave NE
Washington, DC 20019-2010
Grant Number
H80CS22679
Participating Start Date
1/1/2022
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
GRUBBS CARE PHARMACY NW INC.
Pharmacy Address
GRUBB'S NW SPECIALTY PHARMACY
1517 17TH ST NW FL 1
WASHINGTON, DC 20036-6230
Pharmacy Comments
Contract Details
Approval Date
10/22/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Timothy Walker, COO
(202) 803-2340
Contract Pharmacy Representative
Medly
Nate Coney, Vice President
(609) 992-9692
Signed By Date
10/15/2021
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