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SMITH'S PHARMACY #477
FP841024 PLANNED PARENTHOOD ASSOC. OF UTAH
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Covered Entity Details
Entity Name
PLANNED PARENTHOOD ASSOC. OF UTAH
Subdivision Name
SALT LAKE CITY CLINIC
Type
Family Planning (Title X only)
340B ID
FP841024
Entity Address
654 South 900 East
SALT LAKE CITY, UT 84102
Grant Number
FPHPA006544
Participating Start Date
10/1/2022
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
SMITH'S PHARMACY #477
Pharmacy Address
750 N. MAIN ST.
LOGAN, UT 84321
Pharmacy Comments
Contract Details
Approval Date
1/11/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lesley Bailey, CFO
(801) 532-1586
Contract Pharmacy Representative
Smiths Food & Drug Centers
Blair Woolf, Pharmacy Director
(801) 974-1302
Signed By Date
1/11/2016
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