340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CORAM ALTERNATE SITE SERVICES, INC.
DSH500077 PROVIDENCE HEALTH & SERVICES-WASHINGTON
Print
Covered Entity Details
Entity Name
PROVIDENCE HEALTH & SERVICES-WASHINGTON
Subdivision Name
PROVIDENCE HOLY FAMILY HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH500077
Entity Address
5633 NORTH LIDGERWOOD STREET
SPOKANE, WA 99208
Medicare Provider Number
500077
Participating Start Date
7/1/2010
Last Recertification Date
9/11/2024
Pharmacy Details
Pharmacy Name
CORAM ALTERNATE SITE SERVICES, INC.
Pharmacy Address
DBA CORAM CVS/SPECIALTY INFUSION SERVICE
5511 E 3RD AVE
SPOKANE VALLEY, WA 99212-0726
Pharmacy Comments
Contract Details
Approval Date
12/8/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Helen Andrus, CFO
(509) 474-3307
Contract Pharmacy Representative
CVS Health
Kevin Chinn, Director, Health Alliance Development
(858) 260-1446
Signed By Date
12/8/2017
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