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SAFEWAY INC
CH092080 ALLIANCE MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
ALLIANCE MEDICAL CENTER, INC.
Subdivision Name
ALLIANCE MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH092080
Entity Address
1381 UNIVERSITY AVENUE
HEALDSBURG, CA 95448-3314
Grant Number
H80CS00249
Participating Start Date
4/1/1996
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1434
9080 BROOKS RD S
WINDSOR, CA 95492-7811
Pharmacy Comments
04/18/2012 updated address (was 9080 BROOKS ROAD SOUTH)
Contract Details
Approval Date
7/13/2010
Contract Begin Date
7/13/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/2/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JACK L. NEUREUTER, CEO
(707) 433-5494 Ext: 304
Contract Pharmacy Representative
Safeway
Merle Jarvill, Director, Managed Care
(623) 869-4260
Signed By Date
6/23/2010
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