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SAFEWAY INC
CH106290 OUTSIDE IN
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Covered Entity Details
Entity Name
OUTSIDE IN
Subdivision Name
OUTSIDE IN
Type
HRSA-Funded Health Center
340B ID
CH106290
Entity Address
1132 SW 13th Ave
Portland, OR 97205-1703
Grant Number
H80CS00243
Participating Start Date
7/1/1995
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #2448
1010 SW JEFFERSON ST
PORTLAND, OR 97201-3425
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
4/9/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
KATHY OLIVER, CEO
(503) 535-3801
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
4/17/2017
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