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SMITH'S PHARMACY #477
CH08022L COMMUNITY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
Bear River Health Clinic
Type
HRSA-Funded Health Center
340B ID
CH08022L
Entity Address
440 W 600 N
TREMONTON, UT 84337-2400
Grant Number
H80CS00220
Participating Start Date
7/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SMITH'S PHARMACY #477
Pharmacy Address
750 N. MAIN ST.
LOGAN, UT 84321
Pharmacy Comments
Contract Details
Approval Date
4/21/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/8/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DEXTER PEARCE, Executive Director
(801) 412-6920
Contract Pharmacy Representative
Smiths Food & Drug Centers
Blair Woolf, Pharmacy Director
(801) 974-1302
Signed By Date
4/14/2014
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