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SAFEWAY INC
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
SAFEWAY INC
Pharmacy Address
SAFEWAY PHARMACY #1706
1637 N TREKELL RD
CASA GRANDE, AZ 85122
Pharmacy Comments
Contract Details
Approval Date
5/18/2011
Contract Begin Date
5/24/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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