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SAFEWAY INC
CH09208A ALLIANCE MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
ALLIANCE MEDICAL CENTER, INC.
Subdivision Name
Alliance Medical Center - Windsor
Type
HRSA-Funded Health Center
340B ID
CH09208A
Entity Address
8465 Old Redwood Hwy. STE 320
Windsor, CA 95492-9244
Grant Number
H80CS00249
Participating Start Date
1/1/2010
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #0998
1115 VINE ST
HEALDSBURG, CA 95448
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Susannah Labbe, CEO
(707) 480-3898
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
7/17/2023
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