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SMITHS FOOD & DRUG CTRS
CH08380A Midtown Community Health Center, Inc.
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Covered Entity Details
Entity Name
Midtown Community Health Center, Inc.
Subdivision Name
Midtown Community Health Center Davis County Clinic
Type
HRSA-Funded Health Center
340B ID
CH08380A
Entity Address
22 S State St
Clearfield, UT 84015-1043
Grant Number
H80CS00831
Participating Start Date
4/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SMITHS FOOD & DRUG CTRS
Pharmacy Address
SMITH'S FOOD DRUG #149
1170 EAST GENTILE
LAYTON, UT 84040
Pharmacy Comments
Contract Details
Approval Date
1/15/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lisa Nichols, Executive Director
(801) 710-0973
Contract Pharmacy Representative
Smiths Food & Drug Centers
Blair Woolf, Pharmacy Director
(801) 974-1302
Signed By Date
1/15/2016
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