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FRY'S FOOD STORES #699
CH090130 SUNSET COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
SUNSET COMMUNITY HEALTH CENTER
Subdivision Name
SUNSET COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH090130
Entity Address
115 NORTH SOMERTON AVENUE
SOMERTON, AZ 85350-0538
Grant Number
H80CS04321
Participating Start Date
7/1/1997
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
FRY'S FOOD STORES #699
Pharmacy Address
11203 SOUTH FRONTAGE RD.
YUMA, AZ 85367
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/25/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DAVID D ROGERS, CEO
(928) 819-8802
Contract Pharmacy Representative
Kroger
Jessie Warman, Pharmacy Representative
(513) 387-7113
Signed By Date
1/15/2020
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