Contract Pharmacy Details

ALBERTSON'S LLC
CHC12845-00 NATIVE HEALTH

Covered Entity Details

Entity Name

NATIVE HEALTH

Subdivision Name

NATIVE HEALTH West 8800

Type

HRSA-Funded Health Center

340B ID

CHC12845-00

Entity Address

8800 N 22nd Ave
Phoenix, AZ 85021

Grant Number

H80CS12845

Participating Start Date

4/1/2012

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

ALBERTSON'S LLC

Pharmacy Address

OSCO DRUG #2952
8035 NORTH 19TH AVE
PHOENIX, AZ 85021

Pharmacy Comments

Contract Details

Approval Date

7/26/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/24/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Walter Murillo, Chief Executive Officer
(602) 279-5262

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

7/26/2021

340B Drug Pricing Program Database