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FRED MEYER STORES, INC
CH10102BE Sea Mar Community Health Centers
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Covered Entity Details
Entity Name
Sea Mar Community Health Centers
Subdivision Name
Sea Mar CHC - Tillicum Community Center
Type
HRSA-Funded Health Center
340B ID
CH10102BE
Entity Address
14916 Washington Ave. SW
Lakewood, WA 98498-2271
Grant Number
H80CS00445
Participating Start Date
7/1/2012
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
FRED MEYER STORES, INC
Pharmacy Address
FRED MEYER PHARMACY 186
700 SLEATER KINNEY RD SE
LACEY, WA 98503
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary Bartolo, Executive Vice President
(206) 763-5277
Contract Pharmacy Representative
Kroger Health
Eva Brumfield, Strategic Program Director
(651) 357-2109
Signed By Date
10/11/2023
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