Contract Pharmacy Details

SAFEWAY INC
CH101310 CLACKAMAS, COUNTY OF

Covered Entity Details

Entity Name

CLACKAMAS, COUNTY OF

Subdivision Name

Clackamas Health Centers Administration

Type

HRSA-Funded Health Center

340B ID

CH101310

Entity Address

2051 Kaen Road STE 367
Oregon City, OR 97045-4035

Grant Number

H80CS00547

Participating Start Date

4/1/2004

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

SAFEWAY INC

Pharmacy Address

SAFEWAY PHARMACY #2993
13434 COLTON PLACE
OREGON CITY, OR 97045

Pharmacy Comments

Contract Details

Approval Date

11/10/2011

Contract Begin Date

11/10/2011

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

DAVID EDWARDS, FQHC DIRECTOR
(503) 742-5325

Contract Pharmacy Representative

Safeway
Merle Jarvill, Director, Managed Care
(623) 869-4260

Signed By Date

11/11/2011

340B Drug Pricing Program Database