340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SAFEWAY INC
CH09194C MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Print
Covered Entity Details
Entity Name
MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Subdivision Name
Dora Street Health Center, Suite B1
Type
HRSA-Funded Health Center
340B ID
CH09194C
Entity Address
1165 S Dora St Ste B1
Ukiah, CA 95482-6353
Grant Number
H80CS00628
Participating Start Date
7/1/2018
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #0978
660 SOUTH MAIN STREET
FORT BRAGG, CA 95437
Pharmacy Comments
Contract Details
Approval Date
10/24/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rod Grainger, CEO
(707) 472-4667
Contract Pharmacy Representative
Safeway Inc
Joe Lask, Sr. Director Managed Care
(925) 467-2825
Signed By Date
10/24/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session