Contract Pharmacy Details

SAV-ON PHARMACY 165
CH101610 GLENNS FERRY HEALTH CENTER, Inc.

Covered Entity Details

Entity Name

GLENNS FERRY HEALTH CENTER, Inc.

Subdivision Name

DESERT SAGE HEALTH CENTERS

Type

HRSA-Funded Health Center

340B ID

CH101610

Entity Address

486 W. FIRST AVE.
GLENNS FERRY, ID 83623

Grant Number

H80CS00473

Participating Start Date

10/1/1998

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

SAV-ON PHARMACY 165

Pharmacy Address

528 NORTH MAIN STREET
MOUNTAIN HOME, ID 83647

Pharmacy Comments

Contract Details

Approval Date

7/23/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Mary Ferguson, CEO
(208) 366-7416

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

7/23/2018

340B Drug Pricing Program Database