340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KELLEY-ROSS LONG TERM CARE PHARMACY
DSH500064 HARBORVIEW MEDICAL CENTER
Print
Covered Entity Details
Entity Name
HARBORVIEW MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500064
Entity Address
325 9TH AVE.
SEATTLE, WA 98104-2499
Medicare Provider Number
500064
Participating Start Date
12/1/1992
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
KELLEY-ROSS LONG TERM CARE PHARMACY
Pharmacy Address
2324 EASTLAKE AVE E STE 400
SEATTLE, WA 98102-6539
Pharmacy Comments
Contract Details
Approval Date
10/4/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/15/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MAUREEN BROOM, Enterprise Finance Officer
(206) 598-5362
Contract Pharmacy Representative
Kelley-Ross
Alen Chen, Pharmacy Manager
(206) 838-4590
Signed By Date
10/4/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session