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SOAS, LLC
CAH501339-01 WHIDBEY GENERAL HOSPITAL
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Covered Entity Details
Entity Name
WHIDBEY GENERAL HOSPITAL
Subdivision Name
WhidbeyHealth Primary Care - Goldie St.
Type
Critical Access Hospital
340B ID
CAH501339-01
Entity Address
1300 GOLDIE ROAD
OAK HARBOR, WA 98277
Medicare Provider Number
501339
Outpatient Facility Provider Number
503996
Participating Start Date
1/1/2020
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
SOAS, LLC
Pharmacy Address
DBA ISLAND DRUG #1145
230 SE PIONEER WAY
OAK HARBOR, WA 98277
Pharmacy Comments
Contract Details
Approval Date
5/15/2012
Contract Begin Date
5/15/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Hank Hanigan, COO
(360) 678-7656 Ext: 4007
Contract Pharmacy Representative
Aaron Syring, Pharmacist
(360) 341-3885
Signed By Date
5/8/2012
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