Contract Pharmacy Details

SMITH'S PHARMACY #444
FP844035 PLANNED PARENTHOOD ASSOC. OF UTAH

Covered Entity Details

Entity Name

PLANNED PARENTHOOD ASSOC. OF UTAH

Subdivision Name

OGDEN CLINIC

Type

Family Planning (Title X only)

340B ID

FP844035

Entity Address

434 East 5350 South
Unit D
Washington Terrace, UT 84405

Grant Number

FPHPA006544

Participating Start Date

10/1/2022

Last Recertification Date

5/13/2024

Pharmacy Details

Pharmacy Name

SMITH'S PHARMACY #444

Pharmacy Address

555 S. 200 W.
BOUNTIFUL, UT 84010

Pharmacy Comments

Contract Details

Approval Date

7/17/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Lesley Bailey, CFO
(801) 532-1586

Contract Pharmacy Representative

Smiths Food & Drug Centers
Blair Woolf, Pharmacy Director
(801) 974-1302

Signed By Date

7/17/2018

340B Drug Pricing Program Database