340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SAFEWAY INC
CAH381321-00 Grande Ronde Hospital, Inc.
Print
Covered Entity Details
Entity Name
Grande Ronde Hospital, Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH381321-00
Entity Address
900 Sunset Drive
La Grande, OR 97850
Medicare Provider Number
381321
Participating Start Date
4/1/2013
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1160
1600 PLAZA WAY
WALLA WALLA, WA 99362
Pharmacy Comments
Contract Details
Approval Date
7/12/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/7/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Doug Romer, Exec. Director of PCS
(541) 963-1460
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
7/12/2017
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