Contract Pharmacy Details

SAFEWAY INC
FQHCLA225A Maricopa County Special Health Care District

Covered Entity Details

Entity Name

Maricopa County Special Health Care District

Subdivision Name

CHANDLER FAMILY HEALTH CENTER

Type

Health Center Program Look-Alike

340B ID

FQHCLA225A

Entity Address

811 S. HAMILTON
CHANDLER, AZ 85225

Grant Number

LALCS00037

Participating Start Date

10/1/2007

Last Recertification Date

2/14/2019

Entity Termination Date

4/1/2020

Pharmacy Details

Pharmacy Name

SAFEWAY INC

Pharmacy Address

SAFEWAY PHARMACY #2651
340 E. MCDOWELL ROAD
PHOENIX, AZ 85004

Pharmacy Comments

Contract Details

Approval Date

4/29/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Kris Gaw, Chief Operating Officer
(602) 344-1258

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

4/29/2017

340B Drug Pricing Program Database