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SAFEWAY INC
CH09130J CANYONLANDS COMMUNITY HEALTH CARE
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Covered Entity Details
Entity Name
CANYONLANDS COMMUNITY HEALTH CARE
Subdivision Name
Canyonlands Healthcare - Urgent Care
Type
HRSA-Funded Health Center
340B ID
CH09130J
Entity Address
440 NORTH NAVAJO
PAGE, AZ 86040-1625
Grant Number
H80CS00448
Participating Start Date
7/1/2006
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #0249
P.O.BOX 1346
650 ELM STREET
PAGE, AZ 86040
Pharmacy Comments
Contract Details
Approval Date
7/2/2010
Contract Begin Date
7/2/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jaree Chambers, CFO
(928) 645-9675 Ext: 5500
Contract Pharmacy Representative
Safeway
Merle Jarvill, Director, Managed Care
(623) 869-4260
Signed By Date
6/6/2010
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