340B Drug Pricing Program Database
SAFEWAY INC
STD891493 Sagebrush Health Services - information as of 5/10/2025 11:04:11 PM
Covered Entity Details
Entity Name
Sagebrush Health Services
Subdivision Name
Centennial Hills Clinic - KSOSN
Type
Sexually Transmitted Diseases
340B ID
STD891493
Entity Address
8775 Deer Springs Way
Las Vegas, NV 89149
Grant Number
6 NH25PS005179-05-02
Participating Start Date
5/1/2023
Last Recertification Date
6/4/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1517
890 W WILLIAMS
FALLON, NV 89406
Pharmacy Comments
Contract Details
Approval Date
5/1/2023
Contract Begin Date
6/15/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jami Dybik, Vice President
(843) 814-5177
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
4/24/2023
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