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WALGREEN CO.
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
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03788
14510 AURORA AVE N
SHORELINE, WA 98133-6525
Pharmacy Comments
Contract Details
Approval Date
4/1/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Teresita Batayola, CEO
(206) 788-3656
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/1/2015
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