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SAFEWAY INC
CH0814640 CHEYENNE HEALTH AND WELLNESS CENTER
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Covered Entity Details
Entity Name
CHEYENNE HEALTH AND WELLNESS CENTER
Subdivision Name
CHEYENNE HEALTH AND WELLNESS CENTER
Type
HRSA-Funded Health Center
340B ID
CH0814640
Entity Address
2508 EAST FOX FARM ROAD STE 1-1A
CHEYENNE, WY 82007
Grant Number
H80CS04196
Participating Start Date
7/1/2005
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #2667
700 S GREELEY HWY
CHEYENNE, WY 82007
Pharmacy Comments
Contract Details
Approval Date
7/26/2011
Contract Begin Date
7/26/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/25/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
6/23/2011
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