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SMITH'S PHARMACY
CH060240 FIRST CHOICE COMMUNITY HEALTHCARE
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Covered Entity Details
Entity Name
FIRST CHOICE COMMUNITY HEALTHCARE
Subdivision Name
FIRST CHOICE COMMUNITY HEALTH CARE
Type
HRSA-Funded Health Center
340B ID
CH060240
Entity Address
2001 NORTH CENTRO FAMILIAR BOU
ALBUQUERQUE, NM 87105-0000
Grant Number
H80CS00202
Participating Start Date
12/1/1992
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
SMITH'S PHARMACY
Pharmacy Address
02-B HIGHWAY 344
EDGEWOOD, NM 87015
Pharmacy Comments
Contract Details
Approval Date
10/6/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ROBERT DEFELICE, CEO
(505) 873-7401
Contract Pharmacy Representative
Smiths Food & Drug Centers
Blair Woolf, Pharmacy Director
(801) 974-1302
Signed By Date
10/6/2016
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