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SY PHARMACY AND WELLNESS
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
SY PHARMACY AND WELLNESS
Pharmacy Address
3828 S GRAHAM ST UNIT B
SEATTLE, WA 98118-3158
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lakshmi Deepa Yerram, Chief Medical Officer
(206) 788-3652
Contract Pharmacy Representative
SY PHARMACY & WELLNESS
PHUONG SY, OWNER
(206) 880-7768
Signed By Date
10/16/2023
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