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SAFEWAY INC
CH09047AP Golden Valley Health Centers
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Covered Entity Details
Entity Name
Golden Valley Health Centers
Subdivision Name
GVHC - Ceres Whitmore Avenue
Type
HRSA-Funded Health Center
340B ID
CH09047AP
Entity Address
3109 East Whitmore Avenue
Ceres, CA 95307-2906
Grant Number
H80CS00742
Participating Start Date
4/1/2020
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1661
2001 MCHENRY AVENUE
MODESTO, CA 95350
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gurjeet Sandhu, Vice President and Chief Financial Officer
(209) 384-6516
Contract Pharmacy Representative
Safeway
Merle Jarvill, Director, Managed Care
(623) 869-4260
Signed By Date
10/16/2023
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