Contract Pharmacy Details

PUBLIC HEALTH
TB983622 CLALLAM COUNTY HEALTH & HUMAN SERVICES

Covered Entity Details

Entity Name

CLALLAM COUNTY HEALTH & HUMAN SERVICES

Subdivision Name

TB Program

Type

Tuberculosis

340B ID

TB983622

Entity Address

111 E. 3rd St.
Port Angeles, WA 98362

Grant Number

NU52PS910277

Participating Start Date

4/1/1996

Last Recertification Date

5/5/2025

Pharmacy Details

Pharmacy Name

PUBLIC HEALTH

Pharmacy Address

DOWNTOWN CENTRAL PHARMACY
2124 4TH AVE
SEATTLE, WA 98121

Pharmacy Comments

Contract Details

Approval Date

1/24/2012

Contract Begin Date

1/24/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/1/2020
Agreement registered in error

Contacts

Covered Entity Signing Official

Sheanne Allen, TB CONTROLLER
(360) 236-3423

Contract Pharmacy Representative

Benjamin Leifer, Chief Administrative Officer
(206) 263-8696

Signed By Date

12/9/2011

340B Drug Pricing Program Database