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SMITH'S PHARMACY #444
CH08022Q COMMUNITY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
Community Health Centers, Inc - Central City
Type
HRSA-Funded Health Center
340B ID
CH08022Q
Entity Address
610 S 200 E STE #B
Salt Lake City, UT 84111
Grant Number
H80CS00220
Participating Start Date
1/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SMITH'S PHARMACY #444
Pharmacy Address
555 S. 200 W.
BOUNTIFUL, UT 84010
Pharmacy Comments
Contract Details
Approval Date
10/29/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/10/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DEXTER PEARCE, Executive Director
(801) 412-6920
Contract Pharmacy Representative
SFDC
Julie Arellano, Third Party Insurance Coordinator
(801) 974-1402
Signed By Date
10/15/2018
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