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SAFEWAY INC
CH080170A PUEBLO COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
PUEBLO COMMUNITY HEALTH CENTER
Subdivision Name
Colorado Avenue Clinic
Type
HRSA-Funded Health Center
340B ID
CH080170A
Entity Address
300 Colorado Ave
Pueblo, CO 81004-2006
Grant Number
H80CS00692
Participating Start Date
1/1/2000
Last Recertification Date
3/2/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #3729
1231 SOUTH PRAIRIE AVENUE
PUEBLO, CO 81005
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Donald Moore, CEO
(719) 543-8718 Ext: 139
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
4/15/2021
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