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LUKE'S PHARMACY
CH102530 INTERNATIONAL COMMUNITY HEALTH SERVICES
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Covered Entity Details
Entity Name
INTERNATIONAL COMMUNITY HEALTH SERVICES
Subdivision Name
INTERNATIONAL COMMUNITY HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH102530
Entity Address
720 8TH AVENUE SOUTH
SEATTLE, WA 98104-3033
Grant Number
H80CS00437
Participating Start Date
4/1/1995
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
LUKE'S PHARMACY
Pharmacy Address
611 MAYNARD AVE S
SEATTLE, WA 98104-2920
Pharmacy Comments
Contract Details
Approval Date
10/4/2022
Contract Begin Date
11/16/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/11/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Lakshmi Deepa Yerram, Chief Medical Officer
(206) 788-3652
Contract Pharmacy Representative
Luke's Pharmacy
Sam Chan, Owner
(206) 621-8883
Signed By Date
10/4/2022
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