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SAFEWAY INC
CH10102CX Sea Mar Community Health Centers
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Covered Entity Details
Entity Name
Sea Mar Community Health Centers
Subdivision Name
Sea Mar CHC - Kelso Allen St.
Type
HRSA-Funded Health Center
340B ID
CH10102CX
Entity Address
1710 Allen St.
Kelso, WA 98626
Grant Number
H80CS00445
Participating Start Date
7/1/2016
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #4313
904 WEST MAIN STREET
BATTLE GROUND, WA 98604
Pharmacy Comments
Contract Details
Approval Date
10/11/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary Bartolo, Executive Vice President
(206) 763-5277
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/11/2023
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