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OTHELLO STATION PHARMACY
CH100640 NEIGHBORCARE HEALTH
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Covered Entity Details
Entity Name
NEIGHBORCARE HEALTH
Subdivision Name
Neighborcare Health Administration
Type
HRSA-Funded Health Center
340B ID
CH100640
Entity Address
1200 12th AVE S,
Suite 901
Seattle, WA 98144
Grant Number
H80CS00829
Participating Start Date
7/1/1998
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
OTHELLO STATION PHARMACY
Pharmacy Address
SALAAM HEALTH PLLC
4219 S OTHELLO ST # 105F
SEATTLE, WA 98118-3892
Pharmacy Comments
Contract Details
Approval Date
4/10/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rashad A. Collins, CEO
(206) 548-3052
Contract Pharmacy Representative
Othello Station Pharmacy
Ahmed Ali, OWNER
(206) 620-2400
Signed By Date
4/10/2023
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