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SAFEWAY INC
CH10076A NORTHWEST HUMAN SERVICES, INC.
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Covered Entity Details
Entity Name
NORTHWEST HUMAN SERVICES, INC.
Subdivision Name
WEST SALEM CLINIC
Type
HRSA-Funded Health Center
340B ID
CH10076A
Entity Address
1233 EDGEWATER AVENUE, NW
SALEM, OR 97304
Grant Number
H80CS00148
Participating Start Date
7/1/1996
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1516
4990 N. RIVER ROAD
KEIZER, OR 97303
Pharmacy Comments
Contract Details
Approval Date
11/14/2008
Contract Begin Date
11/14/2008
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
9/9/2008
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