Contract Pharmacy Details

SAFEWAY INC
CH106300 BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.

Subdivision Name

BOUNDARY REGIONAL CHC

Type

HRSA-Funded Health Center

340B ID

CH106300

Entity Address

6615 COMANCHE ST
BONNERS FERRY, ID 83805

Grant Number

H80CS00302

Participating Start Date

10/1/2004

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

SAFEWAY INC

Pharmacy Address

SAFEWAY PHARMACY #0350
702 N. 5TH AVENUE
SANDPOINT, ID 83864

Pharmacy Comments

Contract Details

Approval Date

10/15/2013

Contract Begin Date

1/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

VICTORIA McCLELLAN KING, CEO
(208) 263-7101 Ext: 2202

Contract Pharmacy Representative

Safeway
Thuy Le, 340B Program Manager
(925) 467-2825

Signed By Date

10/15/2013

340B Drug Pricing Program Database