Contract Pharmacy Details

SAFEWAY INC
CHC08773-04 Unity Care Northwest

Covered Entity Details

Entity Name

Unity Care Northwest

Subdivision Name

UCNW 1616 Cornwall Avenue

Type

HRSA-Funded Health Center

340B ID

CHC08773-04

Entity Address

1616 Cornwall Ave
Bellingham, WA 98225

Grant Number

H80CS08773

Participating Start Date

7/1/2012

Last Recertification Date

2/27/2025

Pharmacy Details

Pharmacy Name

SAFEWAY INC

Pharmacy Address

HAGGEN PHARMACY #3460
2900 WOBURN ST
BELLINGHAM, WA 98226

Pharmacy Comments

Contract Details

Approval Date

7/27/2016

Contract Begin Date

7/28/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Desmond Skubi, Executive Director
(360) 788-2620

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

7/27/2016

340B Drug Pricing Program Database