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SMITHS FOOD & DRUG CTRS
CHC26644-03 Utah Partners for Health
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Covered Entity Details
Entity Name
Utah Partners for Health
Subdivision Name
Utah Partners for Health Family Health Clinics - West Jordan
Type
HRSA-Funded Health Center
340B ID
CHC26644-03
Entity Address
9103 S 1300 W Ste 102
West Jordan, UT 84088-6709
Grant Number
H80CS26644
Participating Start Date
10/1/2019
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
SMITHS FOOD & DRUG CTRS
Pharmacy Address
SMITH'S DRUG KING PHARMACY #48
1075 EAST MAIN
PRICE, UT 84501
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
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
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
1/13/2020
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