Contract Pharmacy Details

ALBERTSONS LLC
CHC28359-00 SAPPHIRE COMMUNITY HEALTH, INC.

Covered Entity Details

Entity Name

SAPPHIRE COMMUNITY HEALTH, INC.

Subdivision Name

Sapphire Community Health

Type

HRSA-Funded Health Center

340B ID

CHC28359-00

Entity Address

316 N.3rd St.
Hamilton, MT 59840-2405

Grant Number

H80CS28359

Participating Start Date

4/1/2016

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

ALBERTSONS LLC

Pharmacy Address

OSCO PHARMACY #4040
1313 NORTH 1ST STREET
HAMILTON, MT 59840

Pharmacy Comments

Contract Details

Approval Date

10/13/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Janet Woodburn, Interim Chief Executive Officer
(406) 541-0475

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

10/13/2016

340B Drug Pricing Program Database