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SIXTH AVENUE LTC PHARMACY
CH10257B COMMUNITY HEALTH ASSOCIATION OF SPOKANE
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Covered Entity Details
Entity Name
COMMUNITY HEALTH ASSOCIATION OF SPOKANE
Subdivision Name
Valley Clinic
Type
HRSA-Funded Health Center
340B ID
CH10257B
Entity Address
15812 E Indiana Ave
Spokane Valley, WA 99216
Grant Number
H80CS00319
Participating Start Date
1/1/2001
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
SIXTH AVENUE LTC PHARMACY
Pharmacy Address
508 W 6TH AVE
STE 100
SPOKANE, WA 99204
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aaron Wilson, CEO
(509) 444-8888
Contract Pharmacy Representative
Sixth Avenue Medical Pharmacy
Erik Nelson, President
(509) 455-9345
Signed By Date
10/15/2024
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