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PUBLIC HEALTH
STD98104 Planned Parenthood of the Great Northwest and the Hawaiian Islands
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Covered Entity Details
Entity Name
Planned Parenthood of the Great Northwest and the Hawaiian Islands
Subdivision Name
First Hill Health Center
Type
Sexually Transmitted Diseases
340B ID
STD98104
Entity Address
1229 Madison Street Suite 1040
Seattle, WA 98104
Grant Number
NH25PS005146
Participating Start Date
10/1/2012
Last Recertification Date
5/11/2020
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
PUBLIC HEALTH
Pharmacy Address
DOWNTOWN CENTRAL PHARMACY
2124 4TH AVE
SEATTLE, WA 98121
Pharmacy Comments
Contract Details
Approval Date
3/14/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
MARK AUBIN, DIRECTOR - STD SERVICES
(360) 236-3467
Contract Pharmacy Representative
Benjamin Leifer, Chief Administrative Officer
(206) 263-8696
Signed By Date
1/2/2013
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