Contract Pharmacy Details

SMITHS FOOD & DRUG CTRS
CH083800 Midtown Community Health Center, Inc.

Covered Entity Details

Entity Name

Midtown Community Health Center, Inc.

Subdivision Name

MIDTOWN COMMUNITY HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH083800

Entity Address

2240 Adams Ave
Ogden, UT 84401-1511

Grant Number

H80CS00831

Participating Start Date

1/1/2004

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

SMITHS FOOD & DRUG CTRS

Pharmacy Address

DBA SMITH'S FOOD & DRUG #131
1485 HARRISON BLVD
OGDEN, UT 84404

Pharmacy Comments

Contract Details

Approval Date

4/6/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/29/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Alicia Martinez, Chief Executive Officer
(801) 334-1321

Contract Pharmacy Representative

Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875

Signed By Date

4/6/2020

340B Drug Pricing Program Database