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SMITHS FOOD & DRUG CTRS
CH080220 COMMUNITY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
SALT LAKE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH080220
Entity Address
220 W 7200 S
Midvale, UT 84047
Grant Number
H80CS00220
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SMITHS FOOD & DRUG CTRS
Pharmacy Address
DBA SMITHS FOOD & DRUG #137
4643 SOUTH 4000 WEST
WEST VALLEY CITY, UT 84120
Pharmacy Comments
Contract Details
Approval Date
10/2/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DEXTER PEARCE, Executive Director
(801) 412-6920
Contract Pharmacy Representative
Smiths Food & Drug
Jaime Montuoro, Pharmacy Director
(801) 974-1340
Signed By Date
10/2/2020
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