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SAFEWAY INC
CH101030 YAKIMA VALLEY FARM WORKERS CLINIC
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Covered Entity Details
Entity Name
YAKIMA VALLEY FARM WORKERS CLINIC
Subdivision Name
YVFWC - TOPPENISH
Type
HRSA-Funded Health Center
340B ID
CH101030
Entity Address
510 W 1st Ave
Toppenish, WA 98948-1564
Grant Number
H80CS00639
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1629
1265 CENTER ST NE
SALEM, OR 97301
Pharmacy Comments
Contract Details
Approval Date
4/2/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/5/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JUAN CARLOS OLIVARES, CEO
(509) 865-5898 Ext: 2101
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
4/2/2021
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