340B Drug Pricing Program Database
SAFEWAY INC
CAH061319-00 ST. VINCENT GENERAL HOSPITAL - information as of 4/25/2025 6:14:52 PM
Covered Entity Details
Entity Name
ST. VINCENT GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH061319-00
Entity Address
822 WEST 4TH ST.
LEADVILLE, CO 80461
Medicare Provider Number
061319
Participating Start Date
10/1/2023
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #2824
1900 N. POPLAR ST.
LEADVILLE, CO 80461
Pharmacy Comments
Contract Details
Approval Date
10/6/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andrew Dreesen, CEO
(719) 486-7161
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/6/2023
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