340B Drug Pricing Program Database


CH10236B TILLAMOOK, COUNTY OF (Active) - information as of 5/30/2025 8:17:14 PM

Main Details
TILLAMOOK, COUNTY OF
ROCKWAY BEACH CLINIC
HRSA-Funded Health Center
BPS-H80-005330
CH10236B
H80CS00555


Additional Details
Active
7/1/2004
7/1/2004
5/12/2004
2/20/2025

Contacts

Tillamook County Community Health Centers
Marlene Putman, Local Health Administrator
(503) 842-3922

Tillamook County Health Department
Irene M Fitzgerald, Chief Financial Officer
(503) 842-3929

Addresses

276 S Highway 101
Rockaway Beach, OR 97136-9657

TILLAMOOK COUNTY HEALTH DEPARTMENT
PO BOX 489
TILLAMOOK, OR 97141


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
5/23/2008-UPDATED ADD. (WAS 111 SOUTH MILLER STREET);NEW SITE 07/01/200401/21/2010
Medicaid Billing

Yes
Shipping Addresses

TILLAMOOK COUNTY HEALTH DEPARTMENT
801 PACIFIC AVENUE
TILLAMOOK, OR 97141
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #1629 1265 CENTER ST NE
SALEMOR9730106/01/200806/01/2008  03/28/2013
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #0412 1455 EDGEWATER ST NW
SALEMOR9730406/01/200806/01/2008  03/28/2013
Contract DetailSAFEWAY INCSAFEWAY PHARMACY #4404 138 W ELLENDALE AVE
DALLASOR9733806/01/200806/01/2008  03/28/2013
Contract DetailWELLPARTNER, INC20800 SW 115TH AVE SUITE 100
TUALATINOR9706205/01/200605/01/2006  08/31/2016
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH102360ActiveBPS-H80-004296TILLAMOOK, COUNTY OFTILLAMOOK COUNTY HEALTH DEPARTMENT801 Pacific Ave TillamookOR
CH10236BActiveBPS-H80-005330TILLAMOOK, COUNTY OFROCKWAY BEACH CLINIC276 S Highway 101 Rockaway BeachOR
CH10236CTerminatedBPS-H80-003522TILLAMOOK, COUNTY OFTILLAMOOK COUNTY CLOVERDALE CLINIC34335 HIGHWAY 101 S. CLOVERDALEOR
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH102360GENOA HEALTHCARE LLC115 W BOND ST STE P
ASTORIAOR9710307/01/2025  
CH102360SAFEWAY INCSAFEWAY PHARMACY #4404 138 W ELLENDALE AVE
DALLASOR9733806/01/2008  
CH102360SAFEWAY INCSAFEWAY PHARMACY #2723 1815 4TH STREET
TILLAMOOKOR9714103/18/2009  
CH102360SAFEWAY INCSAFEWAY PHARMACY #1629 1265 CENTER ST NE
SALEMOR9730106/01/2008  
CH102360SAFEWAY INCSAFEWAY PHARMACY #0412 1455 EDGEWATER ST NW
SALEMOR9730406/01/2008  
CH10236CSAFEWAY INCSAFEWAY PHARMACY #1629 1265 CENTER ST NE
SALEMOR9730106/01/2008 04/01/2020
CH10236CSAFEWAY INCSAFEWAY PHARMACY #0412 1455 EDGEWATER ST NW
SALEMOR9730406/01/2008 04/01/2020
CH10236CSAFEWAY INCSAFEWAY PHARMACY #4404 138 W ELLENDALE AVE
DALLASOR9733806/01/2008 04/01/2020
CH10236BSAFEWAY INCSAFEWAY PHARMACY #1629 1265 CENTER ST NE
SALEMOR9730106/01/2008  
CH10236BSAFEWAY INCSAFEWAY PHARMACY #0412 1455 EDGEWATER ST NW
SALEMOR9730406/01/2008  
CH10236BSAFEWAY INCSAFEWAY PHARMACY #4404 138 W ELLENDALE AVE
DALLASOR9733806/01/2008  
CH102360WELLPARTNER, INC20800 SW 115TH AVE SUITE 100
TUALATINOR9706205/01/2006  
CH10236CWELLPARTNER, INC20800 SW 115TH AVE SUITE 100
TUALATINOR9706205/01/2006 04/01/2020
CH10236BWELLPARTNER, INC20800 SW 115TH AVE SUITE 100
TUALATINOR9706205/01/2006  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsPrimary ContactUpdateChange RequestFitzgerald, Irene Accounting Manager Tillamook County Health Department 5038423929Fitzgerald, Irene M Chief Financial Officer Tillamook County Health Department 50384239294/24/2025 6:25 AM
DetailsLast Recertification DateUpdateRecertification2/21/2024 11:53:48 AM2/20/2025 12:46:24 PM2/20/2025 12:46 PM
DetailsLast Recertification DateUpdateRecertification2/27/2023 11:53:48 AM2/21/2024 11:53:48 AM2/21/2024 11:53 AM
DetailsLast Recertification DateUpdateRecertification2/17/2022 5:14:36 PM2/27/2023 11:53:48 AM2/27/2023 11:53 AM
DetailsLast Recertification DateUpdateRecertification2/3/2021 5:11:59 PM2/17/2022 5:14:36 PM2/17/2022 5:14 PM
DetailsLast Recertification DateUpdateRecertification2/24/2020 11:01:10 AM2/3/2021 5:11:59 PM2/3/2021 5:11 PM
DetailsLast Recertification DateUpdateRecertification2/27/2019 7:18:07 PM2/24/2020 11:01:10 AM2/24/2020 11:01 AM
DetailsLast Recertification DateUpdateRecertification2/26/2018 12:20:51 PM2/27/2019 7:18:07 PM2/27/2019 7:18 PM
AddressesMain AddressUpdateRecertification 276 Highway 101 S Rockaway Beach, OR 97136-9657 276 S Highway 101 Rockaway Beach, OR 97136-96572/26/2018 12:20 PM
DetailsLast Recertification DateUpdateRecertification2/16/2017 12:00:00 AM2/26/2018 12:20:51 PM2/26/2018 12:20 PM
ContactsPrimary ContactUpdateProfile Change RequestFitzerald, Irene Accounting Manager Tillamook County Health Department 5038423929Fitzgerald, Irene Accounting Manager Tillamook County Health Department 50384239292/20/2018 5:14 PM
ContactsAuthorizing OfficialUpdate Putman, Marlene Local Health Administrator 5038423922Putman, Marlene Local Health Administrator Tillamook County Community Health Centers 50384239222/6/2018 12:38 PM
ContactsPrimary ContactUpdate Fitzerald, Irene Accounting Manager 5038423929Fitzerald, Irene Accounting Manager Tillamook County Health Department 50384239292/1/2018 7:31 PM
ContactsPrimary ContactUpdate HESSE, CURTIS ACTING ADMINISTRATOR 5038423900-3922Fitzerald, Irene Accounting Manager 50384239295/18/2017 9:29 AM
ContactsAuthorizing OfficialUpdate ROBINSON, JOHN E. CEO 5038423922Putman, Marlene Local Health Administrator 50384239225/18/2017 9:29 AM
AddressesMain AddressInsert   276 Highway 101 S Rockaway Beach, OR 97136-96572/16/2017 7:44 PM
DetailsLast Recertification DateUpdate 2/18/2016 12:00:00 AM2/16/2017 12:00:00 AM2/16/2017 7:44 PM
Medicaid BillingMedicaid: Is PrimaryUpdate TrueFalse2/18/2016 2:25 PM
DetailsLast Recertification DateUpdate 3/3/2015 12:00:00 AM2/18/2016 12:00:00 AM2/18/2016 2:25 PM
DetailsLast Recertification DateUpdate 3/15/2014 12:00:00 AM3/3/2015 12:00:00 AM3/3/2015 9:07 AM
AddressesShipping AddressUpdate  TILLAMOOK COUNTY HEALTH DEPARTMENT 801 PACIFIC AVENUE TILLAMOOK, OR 97141TILLAMOOK COUNTY HEALTH DEPARTMENT 801 PACIFIC AVENUE TILLAMOOK, OR 971417/3/2014 4:20 PM
AddressesShipping AddressInsert   TILLAMOOK COUNTY HEALTH DEPARTMENT 801 PACIFIC AVENUE TILLAMOOK, OR 971417/3/2014 4:20 PM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM3/15/2014 12:00:00 AM3/15/2014 7:03 AM
DetailsEntity NameUpdate TILLAMOOK COUNTY HEALTH DEPARTMENTTILLAMOOK, COUNTY OF3/15/2014 7:03 AM
DetailsEntity SubnameUpdate ROCKAWAY BEACH CLINICROCKWAY BEACH CLINIC3/15/2014 7:03 AM
ContactsPrimary ContactInsert  HESSE, CURTIS ACTING ADMINISTRATOR 5038423900-39223/12/2013 11:15 AM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM3/12/2013 11:15 AM
ContactsAuthorizing OfficialInsert  ROBINSON, JOHN E. CEO 50384239221/21/2010 12:03 PM
AddressesBilling AddressInsert  TILLAMOOK COUNTY HEALTH DEPARTMENT PO BOX 489 TILLAMOOK, OR 971411/21/2010 12:02 PM
DetailsLast Recertification DateInsert   1/21/2010 12:02 PM
DetailsGrant NumberInsert  H80CS005551/21/2010 12:02 PM
Details340B IDInsert  CH10236B1/21/2010 12:02 PM
DetailsIs Authorizing Official EHB DataInsert   1/21/2010 12:02 PM
DatesLast Date That 340B Drugs PurchasedInsert   1/21/2010 12:02 PM
DetailsMedicare Provider NumberInsert   1/21/2010 12:02 PM
DetailsEntity NameInsert  TILLAMOOK COUNTY HEALTH DEPARTMENT1/21/2010 12:02 PM
DetailsProgram CodeInsert  CH1/21/2010 12:02 PM
DetailsEntity SubnameInsert  ROCKAWAY BEACH CLINIC1/21/2010 12:02 PM
DatesParticipating Approval DateInsert  5/12/2004 12:00:00 AM1/21/2010 12:02 PM
DetailsStateInsert  Active1/21/2010 12:02 PM
DatesRegistration DateInsert  7/1/2004 12:00:00 AM1/21/2010 12:02 PM
DatesSigned By DateInsert   1/21/2010 12:02 PM
DatesStart DateInsert  7/1/2004 12:00:00 AM1/21/2010 12:02 PM
TerminationsTermination CommentsInsert   1/21/2010 12:02 PM
TerminationsTermination DateInsert   1/21/2010 12:02 PM
TerminationsTermination Effective DateInsert   1/21/2010 12:02 PM
TerminationsTermination ReasonInsert   1/21/2010 12:02 PM
DetailsComments PublicInsert  5/23/2008-UPDATED ADD. (WAS 111 SOUTH MILLER STREET);NEW SITE 07/01/20041/21/2010 12:02 PM
Medicaid BillingMedicaid: Is PrimaryInsert  True7/1/2004 12:00 AM
Medicaid BillingMedicaid: NumberInsert  1287567/1/2004 12:00 AM
Medicaid BillingMedicaid: StateInsert  OR7/1/2004 12:00 AM