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FRED MEYER STORES #215
CH101020 Sea Mar Community Health Centers
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Covered Entity Details
Entity Name
Sea Mar Community Health Centers
Subdivision Name
Sea Mar CHC - Administration
Type
HRSA-Funded Health Center
340B ID
CH101020
Entity Address
1040 S. Henderson St.
Seattle, WA 98108
Grant Number
H80CS00445
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
FRED MEYER STORES #215
Pharmacy Address
25250 PACIFIC HWY SOUTH
KENT, WA 98032
Pharmacy Comments
Contract Details
Approval Date
1/6/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary Bartolo, Executive Vice President
(206) 763-5277
Contract Pharmacy Representative
Kroger
Katie Elfers, 340B Pharmacy Administrator
(513) 762-4850
Signed By Date
1/6/2023
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