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SMITHS FOOD & DRUG CTR INC
CHC26644-02 UTAH PARTNERS FOR HEALTH
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Covered Entity Details
Entity Name
UTAH PARTNERS FOR HEALTH
Subdivision Name
Utah Partners for Health Dental & Behavioral Health
Type
HRSA-Funded Health Center
340B ID
CHC26644-02
Entity Address
7651 S. Main Street
Midvale, UT 84047-8404
Grant Number
H80CS26644
Participating Start Date
1/1/2018
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
SMITHS FOOD & DRUG CTR INC
Pharmacy Address
SMITH'S PHARMACY #147
5620 W 4100 SO
WEST VALLEY CITY, UT 84128
Pharmacy Comments
Contract Details
Approval Date
10/3/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kurt Micka, Executive Director
(801) 417-0131 Ext: 101
Contract Pharmacy Representative
Smiths Food & Drug
Jaime Montuoro, Pharmacy Director
(801) 974-1340
Signed By Date
10/3/2018
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