Contract Pharmacy Details

PUBLIC HEALTH
TB991141 NORTHEAST TRI-COUNTY HEALTH

Covered Entity Details

Entity Name

NORTHEAST TRI-COUNTY HEALTH

Subdivision Name

TB Program

Type

Tuberculosis

340B ID

TB991141

Entity Address

240 E Dominion
COLVILLE, WA 99114

Grant Number

NU52PS910277

Participating Start Date

1/1/1999

Last Recertification Date

5/19/2025

Pharmacy Details

Pharmacy Name

PUBLIC HEALTH

Pharmacy Address

DOWNTOWN CENTRAL PHARMACY
2124 4TH AVE
SEATTLE, WA 98121

Pharmacy Comments

Contract Details

Approval Date

1/24/2012

Contract Begin Date

1/24/2012

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Sheanne Allen, TB CONTROLLER
(360) 236-3423

Contract Pharmacy Representative

Benjamin Leifer, Chief Administrative Officer
(206) 263-8696

Signed By Date

12/9/2011

340B Drug Pricing Program Database