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LINCOLN PHARMACY
CH10102AE Sea Mar Community Health Centers
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Covered Entity Details
Entity Name
Sea Mar Community Health Centers
Subdivision Name
Sea Mar CHC - Burien Ambaum Blvd. SW
Type
HRSA-Funded Health Center
340B ID
CH10102AE
Entity Address
14434 Ambaum Blvd SW
Burien, WA 98166
Grant Number
H80CS00445
Participating Start Date
4/1/2008
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
LINCOLN PHARMACY
Pharmacy Address
821 SOUTH 38TH STREET
TACOMA, WA 98418
Pharmacy Comments
Contract Details
Approval Date
8/9/2011
Contract Begin Date
8/19/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mary Bartolo, VP, Deputy Director
(206) 763-5277
Contract Pharmacy Representative
City Center Drug
Patrick O'Donnell, Owner
(253) 473-1155
Signed By Date
8/2/2011
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