Contract Pharmacy Details

SAFEWAY INC
CH09116B SALUD PARA LA GENTE

Covered Entity Details

Entity Name

SALUD PARA LA GENTE

Subdivision Name

BEACH FLATS HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH09116B

Entity Address

302 Riverside Ave
Santa Cruz, CA 95060-5524

Grant Number

H80CS00226

Participating Start Date

7/1/2012

Last Recertification Date

3/7/2016

Entity Termination Date

4/1/2017

Pharmacy Details

Pharmacy Name

SAFEWAY INC

Pharmacy Address

SAFEWAY PHARMACY #2841
815 CANYON DEL REY
DEL REY OAKS, CA 93940

Pharmacy Comments

Contract Details

Approval Date

10/22/2012

Contract Begin Date

10/22/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/12/2015
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Zettie D. Page, CEO
(831) 728-8250

Contract Pharmacy Representative

Safeway
Merle Jarvill, Director, Managed Care
(623) 869-4260

Signed By Date

9/11/2012

340B Drug Pricing Program Database