Contract Pharmacy Details

SMITH'S FOOD & DRUG CTRS
CHC08229-00 FIRST NATIONS COMMUNITY HEALTH SOURCE INC

Covered Entity Details

Entity Name

FIRST NATIONS COMMUNITY HEALTH SOURCE INC

Subdivision Name

First Nations Community HealthSource

Type

HRSA-Funded Health Center

340B ID

CHC08229-00

Entity Address

5608 Zuni Rd SE
Albuquerque, NM 87108-2926

Grant Number

H80CS08229

Participating Start Date

1/1/2015

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

SMITH'S FOOD & DRUG CTRS

Pharmacy Address

SMITH'S PHARMACY #496
3701 CONSTITUTION NE
ALBUQUERQUE, NM 87110

Pharmacy Comments

Contract Details

Approval Date

11/25/2014

Contract Begin Date

1/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/3/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Linda Son-Stone, CEO
(505) 262-6546

Contract Pharmacy Representative

Karla Langworthy, Pharmacy Director
(505) 256-9443

Signed By Date

11/25/2014

340B Drug Pricing Program Database