Contract Pharmacy Details

SAFEWAY INC
CH09078G Community Medical Centers, Inc.

Covered Entity Details

Entity Name

Community Medical Centers, Inc.

Subdivision Name

Community Medical Centers, Dixon

Type

HRSA-Funded Health Center

340B ID

CH09078G

Entity Address

131 W. A St.
Dixon, CA 95620-3437

Grant Number

H80CS00138

Participating Start Date

10/1/2006

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

SAFEWAY INC

Pharmacy Address

SAFEWAY PHARMACY #1258
1235 STRATFORD AVENUE
DIXON, CA 95620

Pharmacy Comments

Contract Details

Approval Date

10/4/2011

Contract Begin Date

10/7/2011

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

MIKE KIRKPATRICK, CEO
(209) 373-2833

Contract Pharmacy Representative

SAFEWAY PHARMACY
Merle Jarvill, Director of Manages Care
(623) 869-4260

Signed By Date

9/30/2011

340B Drug Pricing Program Database