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SMITH'S FOOD & DRUG CENTERS
FP840605 PLANNED PARENTHOOD ASSOC. OF UTAH
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Covered Entity Details
Entity Name
PLANNED PARENTHOOD ASSOC. OF UTAH
Subdivision Name
Wasatch Clinic
Type
Family Planning (Title X only)
340B ID
FP840605
Entity Address
728 West 100 South, Ste. 1
Heber, UT 84032
Grant Number
FPHPA080562
Participating Start Date
1/1/1998
Last Recertification Date
4/27/2017
Entity Termination Date
7/1/2017
Pharmacy Details
Pharmacy Name
SMITH'S FOOD & DRUG CENTERS
Pharmacy Address
DBA: SMITH'S PHARMACY #80
828 SOUTH 900 WEST
SALT LAKE CITY, UT 84104
Pharmacy Comments
Contract Details
Approval Date
10/21/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2017
Contacts
Covered Entity Signing Official
Penny Davies, Salt Lake City
(501) 532-1586
Contract Pharmacy Representative
Smiths Food & Drug Centers
Blair Woolf, Pharmacy Director
(801) 974-1302
Signed By Date
10/21/2013
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