340B Drug Pricing Program Database

Office of Pharmacy Affairs Logo
Effective Sunday, September 1, OPA is implementing a change to the export format for Medicaid and NPI numbers. This change affects covered entity exports that include Medicaid and/or NPI billing numbers, and the CE Daily Report in Excel format. If the number is associated with more than one state, all the states will be listed between one set of parentheses following the number - for example, 1275575227 (IN,MI,OH). This change is necessary to ensure that the exported data does not exceed Excel’s limit for field length.

OVERLAKE PHARMACY, LLC
CH04102D GREENE COUNTY HEALTH CARE, INCORPORATED

Covered Entity Details

WALSTONBURG HEALTH CENTER
HRSA-Funded Health Center
CH04102D
204 S Main St
Walstonburg, NC 27888
H80CS00088
4/1/2007
2/16/2022
1/1/2023


Pharmacy Details

4124 148TH AVE NE STE JA
REDMOND, WA 98052

Contract Details

7/19/2022
10/1/2022

1/1/2023
Covered Entity Terminated


Contacts


Paul Daniel Perritt, Consulting Chief Financial Officer
(252) 747-8162 Ext: 2001



Overlake Pharmacy LLC
Thao Phan, Pharmacist in Charge
(425) 968-8766
7/19/2022