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SAFEWAY INC
CH102360 TILLAMOOK, COUNTY OF
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Covered Entity Details
Entity Name
TILLAMOOK, COUNTY OF
Subdivision Name
TILLAMOOK COUNTY HEALTH DEPARTMENT
Type
HRSA-Funded Health Center
340B ID
CH102360
Entity Address
801 Pacific Ave
Tillamook, OR 97141-3926
Grant Number
H80CS00555
Participating Start Date
1/1/2004
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1629
1265 CENTER ST NE
SALEM, OR 97301
Pharmacy Comments
Contract Details
Approval Date
6/1/2008
Contract Begin Date
6/1/2008
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
2/16/2007
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