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SMITHS FOOD& DRUG CENTERS
CH10165B FAMILY HEALTH SERVICES CORPORATION
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Covered Entity Details
Entity Name
FAMILY HEALTH SERVICES CORPORATION
Subdivision Name
FAMILY HEALTH SERVICES - BURLEY MEDICAL, DENTAL & BEHAVIORAL HEALTH CLINIC
Type
HRSA-Funded Health Center
340B ID
CH10165B
Entity Address
1309 BENNETT AVE
BURLEY, ID 83318-2676
Grant Number
H80CS00425
Participating Start Date
1/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
SMITHS FOOD& DRUG CENTERS
Pharmacy Address
SMITHS PHARMACY #123
937 E MAIN STREET
BURLEY, ID 83318
Pharmacy Comments
Contract Details
Approval Date
8/17/2010
Contract Begin Date
8/17/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
8/16/2010
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