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SAFEWAY INC
CH080030 VALLEY-WIDE HEALTH SYSTEMS, INC.
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Covered Entity Details
Entity Name
VALLEY-WIDE HEALTH SYSTEMS, INC.
Subdivision Name
Alamosa Family Medical Center, Valley Wide Pharmacy, or Anti-Coagulation Clinic
Type
HRSA-Funded Health Center
340B ID
CH080030
Entity Address
1710 1st St
Alamosa, CO 81101
Grant Number
H80CS00134
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #3723
315 W 2ND STREET
LA JUNTA, CO 81050
Pharmacy Comments
Contract Details
Approval Date
2/15/2012
Contract Begin Date
2/15/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeanne Darricades, CEO
(719) 589-5161
Contract Pharmacy Representative
SAFEWAY PHARMACY
Merle Jarvill, Director of Manages Care
(623) 869-4260
Signed By Date
2/7/2012
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