Contract Pharmacy Details

SAFEWAY INC
CHC24176-00 OLATHE COMMUNITY CLINIC, INC.

Covered Entity Details

Entity Name

OLATHE COMMUNITY CLINIC, INC.

Subdivision Name

Olathe Community Clinic, Inc.

Type

HRSA-Funded Health Center

340B ID

CHC24176-00

Entity Address

308 Main Street
Olathe, CO 81425

Grant Number

H80CS24176

Participating Start Date

4/1/2014

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

SAFEWAY INC

Pharmacy Address

SAFEWAY PHARMACY #1863
1550 HIGHWAY 92
DELTA, CO 81416

Pharmacy Comments

Contract Details

Approval Date

1/13/2015

Contract Begin Date

4/1/2015

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

DEBORAH HARRISON-ZARKIS, CEO
(970) 263-1707

Contract Pharmacy Representative

Safeway
Thuy Le, 340B Program Manager
(925) 467-2825

Signed By Date

1/13/2015

340B Drug Pricing Program Database