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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 #0253
3185 W. APACHE TRAIL
APACHE JUNCTION, AZ 85120
Pharmacy Comments
Contract Details
Approval Date
7/14/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TRAVIS ROBINETTE, CEO
(520) 836-3446 Ext: 2303
Contract Pharmacy Representative
Safeway
Thuy Le, 340B Program Manager
(925) 467-2825
Signed By Date
7/14/2014
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