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SAFEWAY PHARMACY #2808
RWII20010 District of Columbia Department of Health
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Covered Entity Details
Entity Name
District of Columbia Department of Health
Subdivision Name
Us Helping Us, People Into Living Inc.
Type
Ryan White Part B
340B ID
RWII20010
Entity Address
3636 Georgia Ave. NW
Washington, DC 20010
Grant Number
X07HA00045
Participating Start Date
7/1/2020
Last Recertification Date
2/8/2022
Entity Termination Date
7/1/2022
Pharmacy Details
Pharmacy Name
SAFEWAY PHARMACY #2808
Pharmacy Address
3830 GEORGIA AVENUE, NW
WASHINGTON, DC 20011
Pharmacy Comments
Contract Details
Approval Date
10/8/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
DeMarc Anthony Hickson, Executive Director
(202) 446-1100 Ext: 1092
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/8/2020
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