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SAFEWAY INC
HV090750 MARICOPA COUNTY SPECIALTY HEALTH CARE DISTRICT
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Covered Entity Details
Entity Name
MARICOPA COUNTY SPECIALTY HEALTH CARE DISTRICT
Subdivision Name
Valleywise Community Health Center - McDowell
Type
Ryan White Part C
340B ID
HV090750
Entity Address
Valleywise Community Health Center - McDowell
1101 N. Central Ave.
Ste. 204
PHOENIX, AZ 85004
Grant Number
H76HA00151
Participating Start Date
7/1/1995
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #2651
340 E. MCDOWELL ROAD
PHOENIX, AZ 85004
Pharmacy Comments
Contract Details
Approval Date
4/17/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2017
Business decision by covered entity and/or pharmacy
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
4/17/2017
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