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SMITHS FOOD & DRUG CENTERS
CH090030 SUN LIFE FAMILY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
SUN LIFE FAMILY HEALTH CENTER, INC.
Subdivision Name
Sun Life Health - Casa Grande Family Practice, Dental & Orthodontics
Type
HRSA-Funded Health Center
340B ID
CH090030
Entity Address
865 N Arizola Rd
Casa Grande, AZ 85122-6011
Grant Number
H80CS00466
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
SMITHS FOOD & DRUG CENTERS
Pharmacy Address
DBA FRYS FOOD & DRUG #48
1385 E FLORENCE BLVD.
CASA GRANDE, AZ 85122
Pharmacy Comments
Contract Details
Approval Date
9/30/2010
Contract Begin Date
9/30/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
9/17/2010
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