Contract Pharmacy Details

SAFEWAY INC
CHC08774-00 COMMUNITY HEALTH OF CENTRAL WASHINGTON

Covered Entity Details

Entity Name

COMMUNITY HEALTH OF CENTRAL WASHINGTON

Subdivision Name

Central Washington Family Medicine

Type

HRSA-Funded Health Center

340B ID

CHC08774-00

Entity Address

1806 W Lincoln Ave
Yakima, WA 98902-2473

Grant Number

H80CS08774

Participating Start Date

9/9/2005

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

SAFEWAY INC

Pharmacy Address

SAFEWAY PHARMACY #0462
205 NORTH 5TH AVENUE
YAKIMA, WA 98902

Pharmacy Comments

Contract Details

Approval Date

8/3/2012

Contract Begin Date

8/3/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/14/2016
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Paul Kaschmitter, CFO
(509) 574-6110

Contract Pharmacy Representative

Safeway
Merle Jarvill, Director, Managed Care
(623) 869-4260

Signed By Date

7/23/2012

340B Drug Pricing Program Database