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SAFEWAY INC
CH080900 PEAK VISTA COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
Health Center at Limon
Type
HRSA-Funded Health Center
340B ID
CH080900
Entity Address
820 1st St
Limon, CO 80828
Grant Number
H80CS00212
Participating Start Date
4/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1644
7655 MCLAUGHLIN RD
FALCON, CO 80831
Pharmacy Comments
Contract Details
Approval Date
1/12/2012
Contract Begin Date
1/12/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/31/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Morgan Honea, CEO
(719) 775-1095
Contract Pharmacy Representative
SAFEWAY PHARMACY
Merle Jarvill, Director of Manages Care
(623) 869-4260
Signed By Date
11/30/2011
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