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SAFEWAY INC
CH101520 TRI-CITIES COMMUNITY HEALTH
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Covered Entity Details
Entity Name
TRI-CITIES COMMUNITY HEALTH
Subdivision Name
TCCH Pasco-Medical, Pharmacy & Optometry
Type
HRSA-Funded Health Center
340B ID
CH101520
Entity Address
515 W Court St
Pasco, WA 99301-3737
Grant Number
H80CS00498
Participating Start Date
7/1/1996
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #0335
2825 W KENNEWICK AVE
KENNEWICK, WA 99336
Pharmacy Comments
Contract Details
Approval Date
4/15/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/7/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Esleen Fultz, CFO
(509) 547-2204
Contract Pharmacy Representative
Safeway
Thuy Le, 340B Program Manager
(925) 467-2825
Signed By Date
4/15/2014
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