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SAFEWAY INC
DSH060011 DENVER HEALTH MEDICAL CENTER
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Covered Entity Details
Entity Name
DENVER HEALTH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH060011
Entity Address
777 BANNOCK ST
DENVER, CO 80204
Medicare Provider Number
060011
Participating Start Date
12/1/1992
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1568
40 COUNTY RD #804
P.O. BOX 218
FRASER, CO 80442
Pharmacy Comments
Contract Details
Approval Date
10/18/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/26/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
PEG BURNETTE, CFO, DENVER HEALTH AND HOSPITAL AUTHORITY
(303) 602-4964
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/18/2016
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