340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SAFEWAY INC
FQHC638492 COW CREEK BAND OF UMPQUA TRIBE OF INDIANS
Print
Covered Entity Details
Entity Name
COW CREEK BAND OF UMPQUA TRIBE OF INDIANS
Subdivision Name
COW CREEK HEALTH AND WELLNESS CENTER
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638492
Entity Address
2589 NW Edenbower Blvd
ROSEBURG, OR 97471-6220
Grant Number
Participating Start Date
7/1/2019
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #4904
821 SOUTH MAIN STREET
MYRTLE CREEK, OR 97457
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dennis Edmond Eberhardt, Clinic Director
(541) 677-5510
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
7/12/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session