Contract Pharmacy Details

SAFEWAY INC
CH10070A WHITE BIRD CLINIC

Covered Entity Details

Entity Name

WHITE BIRD CLINIC

Subdivision Name

WHITE BIRD MEDICAL/DENTAL CLINIC

Type

HRSA-Funded Health Center

340B ID

CH10070A

Entity Address

1400 Mill St
Eugene, OR 97401-4259

Grant Number

H80CS00055

Participating Start Date

10/1/2014

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

SAFEWAY INC

Pharmacy Address

SAFEWAY PHARMACY #4288
145 EAST 18TH STREET
EUGENE, OR 97401

Pharmacy Comments

Contract Details

Approval Date

1/15/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Miles Alan Mabray, Executive Coordinator
(530) 228-6899

Contract Pharmacy Representative

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

Signed By Date

1/15/2018

340B Drug Pricing Program Database