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SMITHS FOOD & DRUG CTRS
FP004219 PLANNED PARENTHOOD ASSOC. OF UTAH
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Covered Entity Details
Entity Name
PLANNED PARENTHOOD ASSOC. OF UTAH
Subdivision Name
WEST VALLEY CLINIC
Type
Family Planning (Title X only)
340B ID
FP004219
Entity Address
1906 WEST 3600 SOUTH
WEST VALLEY CITY, UT 84119
Grant Number
FPHPA006544
Participating Start Date
10/1/2022
Last Recertification Date
5/13/2024
Pharmacy Details
Pharmacy Name
SMITHS FOOD & DRUG CTRS
Pharmacy Address
DBA SMITH'S FOOD & DRUG #136
350 NORTH FREEDOM BOULEVARD
PROVO, UT 84601
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
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