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SAFEWAY INC
CH10236B TILLAMOOK, COUNTY OF
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Covered Entity Details
Entity Name
TILLAMOOK, COUNTY OF
Subdivision Name
ROCKWAY BEACH CLINIC
Type
HRSA-Funded Health Center
340B ID
CH10236B
Entity Address
276 S Highway 101
Rockaway Beach, OR 97136-9657
Grant Number
H80CS00555
Participating Start Date
7/1/2004
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #0412
1455 EDGEWATER ST NW
SALEM, OR 97304
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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