340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SAFEWAY INC
CAH501312-00 PROSSER MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
PROSSER MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH501312-00
Entity Address
200 Prosser Health Drive
PROSSER, WA 99350
Medicare Provider Number
501312
Participating Start Date
4/1/2019
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1593
610 E. WINE COUNTRY ROAD
GRANDVIEW, WA 98930
Pharmacy Comments
Contract Details
Approval Date
7/25/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
TIM COOPER, CFO
(509) 786-2222 Ext: 6051
Contract Pharmacy Representative
Safeway
Thuy Le, 340B Program Manager
(925) 467-2825
Signed By Date
7/25/2014
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session