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ALBERTSONS LLC
CH10163L Valley Family Health Care, Inc.
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Covered Entity Details
Entity Name
Valley Family Health Care, Inc.
Subdivision Name
Valley Family Health Care Mobile Unit (MAC)
Type
HRSA-Funded Health Center
340B ID
CH10163L
Entity Address
1441 NE 10th Ave
Payette, ID 83661-5420
Grant Number
H80CS00556
Participating Start Date
7/1/2019
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
ALBERTSONS LLC
Pharmacy Address
SAV-ON PHARMACY #168
405 S MAIN ST
PAYETTE, ID 83661
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ben Murray, COO
(208) 642-7364
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/13/2023
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