Contract Pharmacy Details

SAFEWAY INC
DSH060011 DENVER HEALTH MEDICAL CENTER

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 #2246
757 E 20TH AVE
DENVER, CO 80205-3278

Pharmacy Comments

Contract Details

Approval Date

10/18/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

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

340B Drug Pricing Program Database