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ALBERTSON'S LLC
CHC330723-01 UNIVERSITY OF WYOMING
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Covered Entity Details
Entity Name
UNIVERSITY OF WYOMING
Subdivision Name
University of Wyoming Family Medicine Residency Cheyenne
Type
HRSA-Funded Health Center
340B ID
CHC330723-01
Entity Address
820 E 17th St
Cheyenne, WY 82001-4775
Grant Number
H80CS30723
Participating Start Date
10/1/2017
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
ALBERTSON'S LLC
Pharmacy Address
OSCO PHARMACY #65
3355 EAST PERSHING BOULEVARD
CHEYENNE, WY 82001
Pharmacy Comments
Contract Details
Approval Date
4/8/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diana Grant Hulme, Associate Vice President Research
(307) 766-6811
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
4/8/2019
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