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SOLDOTNA PROFESSIONAL PHRMCY
CH10717A PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC.
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Covered Entity Details
Entity Name
PENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC.
Subdivision Name
Peninsula Community Health Services of Alaska
Type
HRSA-Funded Health Center
340B ID
CH10717A
Entity Address
230 East Marydale Ave
SOLDOTNA, AK 99669-7524
Grant Number
H80CS01139
Participating Start Date
10/1/2015
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
SOLDOTNA PROFESSIONAL PHRMCY
Pharmacy Address
299 N BINKLEY STREET
SOLDOTNA, AK 99669
Pharmacy Comments
Contract Details
Approval Date
7/15/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Monica Adams, CEO
(907) 260-7300
Contract Pharmacy Representative
Jeff Ruffridge, Owner
(907) 262-3800
Signed By Date
7/15/2016
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