Covered Entity Details

FQHCLA405B CASCADE AIDS PROJECT (Active) - information as of 6/12/2025 9:36:21 PM

Main Details

Name

CASCADE AIDS PROJECT

Subdivision Name

Prism Health

Type

Health Center Program Look-Alike

Site ID

BPS-LAL-038324

340B ID

FQHCLA405B

Grant Number

LALCS33965

Additional Details

Current Program Status

Active

Registration Date

5/9/2024

Participating Start Date

7/1/2024

Participating Approval Date

5/13/2024

Last Recertification Date

2/24/2025

Contacts

Authorizing Official

Cascade AIDS Project
Jessica Cole, Senior Director of Compliance & Risk Management
(503) 445-7699

Primary Contact

Cascade AIDS Project
Kevin Bumatay, Chief Finance & Operations Officer
(503) 223-5907

Addresses

Street Address

15 N Morris St
Portland, OR 97227-1541

Billing Address

Cascade AIDS Project
520 NW Davis Street
Suite 215
Portland, OR 97209

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
FQHCLA405	Active	BPS-LAL-030392	Cascade Aids Project	Prism Health	2236 SE Belmont St	Portland	OR
FQHCLA405A	Active	BPS-LAL-030390	Cascade Aids Project	Cascade AIDS Project	520 NW Davis St Ste 215	Portland	OR
FQHCLA405B	Active	BPS-LAL-038324	CASCADE AIDS PROJECT	Prism Health	15 N Morris St	Portland	OR

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
FQHCLA405	1ST AVENUE PHARMACY	DBA GENOA HEALTHCARE, LLC	6 E 1ST AVENUE	SPOKANE	WA	99202	01/01/2022
FQHCLA405	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/01/2022
FQHCLA405	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/01/2022
FQHCLA405	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/01/2022
FQHCLA405	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/01/2022
FQHCLA405A	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/01/2022
FQHCLA405	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/01/2022
FQHCLA405	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	01/01/2022
FQHCLA405	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	01/01/2025
FQHCLA405	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	04/21/2020
FQHCLA405	AVITA DRUGS OREGON LLC	DBA: AVITA PHARMACY 1027	2236 SE BELMONT ST STE A	PORTLAND	OR	97214-2817	04/21/2020
FQHCLA405A	AVITA DRUGS OREGON LLC	DBA: AVITA PHARMACY 1027	2236 SE BELMONT ST STE A	PORTLAND	OR	97214-2817	07/01/2020
FQHCLA405A	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	10/01/2022
FQHCLA405	AVITA PHARMACY 1025	PHARMEDQUEST PHARMACY SERVICES DBA AVITA	3020 SATURN ST STE 100	BREA	CA	92821	10/01/2022
FQHCLA405	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	04/21/2020
FQHCLA405A	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	07/01/2020
FQHCLA405	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	04/21/2020
FQHCLA405	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4900 PROSPECTUS DR STE 300		DURHAM	NC	27713	04/21/2020
FQHCLA405	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	04/21/2020
FQHCLA405	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	145 S 79TH ST STE 70	CHANDLER	AZ	85226	01/01/2025
FQHCLA405	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4740 VICTORY LN STE C	INDIANAPOLIS	IN	46203	01/01/2025
FQHCLA405	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	04/21/2020
FQHCLA405	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	04/21/2020
FQHCLA405	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	04/21/2020
FQHCLA405	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	04/21/2020
FQHCLA405	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	04/21/2020
FQHCLA405	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	04/21/2020
FQHCLA405	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	04/21/2020
FQHCLA405	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	04/21/2020
FQHCLA405	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/21/2020
FQHCLA405	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2021
FQHCLA405	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	04/01/2022
FQHCLA405	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	04/01/2022
FQHCLA405	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	04/21/2020
FQHCLA405	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	04/21/2020
FQHCLA405	DOGWOOD PHARMACY, INC	D/B/A MEDSCRIPTS MEDICAL PHARMACY	1325 MILLER ROAD SUITE K	GREENVILLE	SC	29607-6540	04/21/2020
FQHCLA405	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	01/01/2022
FQHCLA405	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	01/01/2022
FQHCLA405	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	01/01/2022
FQHCLA405	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	01/01/2022
FQHCLA405	FRED MEYER	3805 SE HAWTHORNE BLVD		PORTLAND	OR	97214	01/01/2021
FQHCLA405	FRED MEYER	7404 N. INTERSTATE AVE		PORTLAND	OR	97217	01/01/2021
FQHCLA405	GARFIELD BEACH CVS, L.L.C.	DBA: CVS/PHARMACY # 09674	1050 W. SUNSET BOULEVARD	LOS ANGELES	CA	90012	04/21/2020
FQHCLA405	GENOA HEALTHCARE LLC	18417 SE OAK STREET		PORTLAND	OR	97233	01/01/2022
FQHCLA405	GENOA HEALTHCARE LLC	2045 SILVERTON RD NE STE B		SALEM	OR	97301	01/01/2022
FQHCLA405	GENOA HEALTHCARE LLC	11000 LAKE CITY WAY NE STE 421		SEATTLE	WA	98125	01/01/2022
FQHCLA405	GENOA HEALTHCARE LLC	6 E 1ST AVE		SPOKANE	WA	99202	01/01/2022
FQHCLA405	GENOA HEALTHCARE LLC	10700 SW BEAVERTON HILLSDALE HWY	BLDG 1, RM 122	BEAVERTON	OR	97005	01/01/2022
FQHCLA405	HEALTHY OPTIONS INC	DBA POSTAL PRESCRIPTION SVCS	3500 SE 26TH AVE PO BOX 2718	PORTLAND	OR	97202	01/01/2021
FQHCLA405	HIGHLAND PARK CVS, L.L.C.	DBA: CVS/PHARMACY # 08751	4051 N LINCOLN	CHICAGO	IL	60618	01/01/2022
FQHCLA405	LONGS DRUG STORES CALIFORNIA, L.L.C.	DBA: CVS/PHARMACY # 09815	738 BANCROFT RD	WALNUT CREEK	CA	94598	01/01/2022
FQHCLA405	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	04/21/2020
FQHCLA405	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	04/21/2020
FQHCLA405	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 00187	14125 STEELE CREEK RD.	CHARLOTTE	NC	28273	01/01/2022
FQHCLA405	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/01/2022
FQHCLA405	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	01/01/2022
FQHCLA405A	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/01/2024
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 17632	1555 N TOMAHAWK ISLAND DR	PORTLAND	OR	97217	07/01/2020	07/01/2020
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16757	9800 SE WASHINGTON ST	PORTLAND	OR	97216	04/21/2020
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16125	10775 SW BEAVERTON HILLSDALE HWY	BEAVERTON	OR	97005	04/21/2020
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 17640	939 SW MORRISON ST	PORTLAND	OR	97205	07/01/2020	07/01/2020
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16127	9000 SE SUNNYSIDE RD	CLACKAMAS	OR	97015	04/21/2020
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 17632	1555 N TOMAHAWK ISLAND DR	PORTLAND	OR	97217	10/01/2020
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 17640	939 SW MORRISON ST	PORTLAND	OR	97205	10/01/2020	10/06/2023
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS/PHARMACY # 11150	12555 NW CORNELL RD	PORTLAND	OR	97229	01/01/2022
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS/PHARMACY # 11292	345 SW HARRISON ST	PORTLAND	OR	97201	01/01/2022
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16126	9009 SW HALL BLVD	TIGARD	OR	97223	01/01/2022
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16336	18101 NW EVERGREEN PKWY	BEAVERTON	OR	97006	01/01/2022
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS PHARMACY # 16967	25925 SW HEATHER PL	WILSONVILLE	OR	97070	01/01/2022
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	CVS/PHARMACY # 17731	3031 SE POWELL BLVD.	PORTLAND	OR	97202	01/01/2022	10/06/2023
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #17793	4030 NE HALSEY STREET	PORTLAND	OR	97232	01/01/2022	10/06/2023
FQHCLA405	OREGON CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #11392	1821 NE 33RD AVENUE	PORTLAND	OR	97212	04/01/2022
FQHCLA405	OVERLAKE PHARMACY, LLC	4124 148TH AVE NE STE JA		REDMOND	WA	98052	04/21/2020
FQHCLA405A	PHARMA BUDDIES CORP	ROSEMONT SPECIALTY PHARMACY	1727 ORLANDO CENTRAL PKWY	ORLANDO	FL	32809	07/01/2024
FQHCLA405	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	04/21/2020
FQHCLA405	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	04/21/2020
FQHCLA405	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	04/21/2020
FQHCLA405	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #11280	538 SW 4TH AVENUE	PORTLAND	OR	97204	04/21/2020
FQHCLA405	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2819	1309 NW 23RD AVE.	PORTLAND	OR	97210	04/21/2020
FQHCLA405	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2021
FQHCLA405	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2021
FQHCLA405	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	04/21/2020
FQHCLA405	RIVER MEDICAL PHARMACY LLC	4752 RESEARCH DR		SAN ANTONIO	TX	78240-5002	04/21/2020
FQHCLA405	SAFEWAY INC	SAFEWAY PHARMACY #0509	5920 NE MLK BLVD	PORTLAND	OR	97211	01/01/2021
FQHCLA405	SAFEWAY INC	SAFEWAY PHARMACY #3134	2800 SE HAWTHORNE BLVD	PORTLAND	OR	97214	01/01/2021
FQHCLA405	TRUEPILL	3121 DIABLO AVE		HAYWARD	CA	94545	04/21/2020
FQHCLA405	WALGREEN CO.	DBA: WALGREENS # 06140	1620 NE GRAND AVE	PORTLAND	OR	97232	04/21/2020
FQHCLA405	WALGREEN CO.	DBA: WALGREENS # 05572	2829 N LOMBARD ST	PORTLAND	OR	97217	04/21/2020
FQHCLA405	WALGREEN CO.	DBA: WALGREENS # 03925	3 NE 82ND AVE	PORTLAND	OR	97220	04/21/2020
FQHCLA405	WALGREEN CO.	DBA: WALGREENS # 04296	3909 SE HOLGATE BLVD	PORTLAND	OR	97202	04/21/2020
FQHCLA405	WALGREEN CO.	DBA: WALGREENS # 03890	940 SE CESAR E CHAVEZ BLVD	PORTLAND	OR	97214	04/21/2020
FQHCLA405	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #21151	1215 NW 23RD AVE	PORTLAND	OR	97210	04/21/2020
FQHCLA405	WALGREEN CO.	DBA: WALGREENS # 07119	5420 NE 33RD AVE	PORTLAND	OR	97211-7404	04/21/2020
FQHCLA405	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	04/21/2020
FQHCLA405	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	04/21/2020
FQHCLA405	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	04/21/2020
FQHCLA405	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/21/2020
FQHCLA405	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	04/21/2020
FQHCLA405	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	04/21/2020
FQHCLA405	WESTERN PHARMACY GROUP LLC	DBA COMMUNITY MEDICAL CENTER PHARMACY	610 GATEWAY CENTER WAY SUITES A--E	SAN DIEGO	CA	92102	04/21/2020

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		2/24/2025 2:27:48 PM	2/24/2025 2:27 PM
Contacts	Authorizing Official	Update	Profile Change Request	Cole, Jessica Director of Healthcare Operations Cascade AIDS Project 5034457699	Cole, Jessica Senior Director of Compliance & Risk Management Cascade AIDS Project 5034457699	2/24/2025 2:26 PM
Contacts	Signed By	Update	Profile Change Request	Cole, Jessica Director of Healthcare Operations Cascade AIDS Project 5034457699	Cole, Jessica Senior Director of Compliance & Risk Management Cascade AIDS Project 5034457699	2/24/2025 2:26 PM
Contacts	Primary Contact	Update	Change Request	Phipps, Aaron Director of Financial Planning & Analysis Cascade AIDS Project 5032235907	Bumatay, Kevin Chief Finance & Operations Officer Cascade AIDS Project 5032235907	7/30/2024 6:41 AM
Details	State	Update		Approved	Active	7/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Cole, Jessica Director of Healthcare Operations Cascade AIDS Project 5034457699	5/13/2024 9:34 AM
Details	340B ID	Update	New Registration		FQHCLA405B	5/13/2024 9:34 AM
Dates	Participating Approval Date	Update	New Registration		5/13/2024 9:34:58 AM	5/13/2024 9:34 AM
Details	State	Update	New Registration	Pending	Approved	5/13/2024 9:34 AM
Dates	Signed By Date	Update	New Registration		5/9/2024 2:49:59 PM	5/13/2024 9:34 AM
Dates	Start Date	Update	New Registration		7/1/2024 12:00:00 AM	5/13/2024 9:34 AM
Addresses	Main Address	Insert	New Registration		15 N Morris St Portland, OR 97227-1541	5/9/2024 2:49 PM
Addresses	Billing Address	Insert	New Registration		Cascade AIDS Project 520 NW Davis Street Suite 215 Portland, OR 97209	5/9/2024 2:49 PM
Contacts	Authorizing Official	Insert	New Registration		Cole, Jessica Director of Healthcare Operations Cascade AIDS Project 5034457699	5/9/2024 2:49 PM
Contacts	Primary Contact	Insert	New Registration		Phipps, Aaron Director of Financial Planning & Analysis Cascade AIDS Project 5032235907	5/9/2024 2:49 PM
Details	Assistance Received From Date	Insert	New Registration			5/9/2024 2:49 PM
Details	Assistance Received To Date	Insert	New Registration			5/9/2024 2:49 PM
Details	Last Recertification Date	Insert	New Registration			5/9/2024 2:49 PM
Details	Grant Number	Insert	New Registration		LALCS33965	5/9/2024 2:49 PM
Details	340B ID	Insert	New Registration			5/9/2024 2:49 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			5/9/2024 2:49 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			5/9/2024 2:49 PM
Details	Medicare Provider Number	Insert	New Registration			5/9/2024 2:49 PM
Details	Entity Name	Insert	New Registration		CASCADE AIDS PROJECT	5/9/2024 2:49 PM
Details	NOFO Number	Insert	New Registration			5/9/2024 2:49 PM
Details	Program Code	Insert	New Registration		FQHCLA	5/9/2024 2:49 PM
Details	Entity Subname	Insert	New Registration		Prism Health	5/9/2024 2:49 PM
Dates	Participating Approval Date	Insert	New Registration			5/9/2024 2:49 PM
Details	State	Insert	New Registration		Pending	5/9/2024 2:49 PM
Dates	Registration Date	Insert	New Registration		5/9/2024 2:49:55 PM	5/9/2024 2:49 PM
Dates	Signed By Date	Insert	New Registration			5/9/2024 2:49 PM
Dates	Start Date	Insert	New Registration			5/9/2024 2:49 PM
Terminations	Termination Comments	Insert	New Registration			5/9/2024 2:49 PM
Terminations	Termination Date	Insert	New Registration			5/9/2024 2:49 PM
Terminations	Termination Effective Date	Insert	New Registration			5/9/2024 2:49 PM
Terminations	Termination Reason	Insert	New Registration			5/9/2024 2:49 PM

340B Drug Pricing Program Database