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SAFEWAY INC
CH09107BT San Francisco Community Clinic Consortium
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Covered Entity Details
Entity Name
San Francisco Community Clinic Consortium
Subdivision Name
Saint Anthony Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH09107BT
Entity Address
150 Golden Gate Ave Fl 2
San Francisco, CA 94102-3810
Grant Number
H80CS00049
Participating Start Date
7/1/2021
Last Recertification Date
2/24/2022
Entity Termination Date
7/1/2022
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1507
2020 MARKET STREET
*ATTENTION PHAMACY MANAGER*
SAN FRANCISCO, CA 94114
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
Kate O'Connor, Clinic Director
(415) 592-2711
Contract Pharmacy Representative
Safeway #1507
Rebekah Aziz, Pharmacy Manager
(415) 436-9032
Signed By Date
4/15/2021
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