340B Drug Pricing Program Database


CH10291A KLAMATH HEALTH PARTNERSHIP, INC (Active) - information as of 5/5/2025 11:52:30 PM

Main Details
KLAMATH HEALTH PARTNERSHIP, INC
CHILOQUIN OPEN DOOR FAMILY PRACTICE
HRSA-Funded Health Center
BPS-H80-000776
CH10291A
H80CS00233


Additional Details
Active
11/10/2009
1/1/2010
11/10/2009
2/11/2025

Contacts

Klamath Health Partnership
Erich Koch, CEO
(541) 810-2040

Klamath Health Partnership, Inc
Marcus Cox, Chief Pharmacy Officer
(541) 887-8188

Addresses

103 WASCO STREET
CHILOQUIN, OR 97624

KLAMATH HEALTH PARTNERSHIP, INC.
2074 SOUTH 6TH STREET
KLAMATH FALLS, OR 97601


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
OR170061,5007198981225291503,1689023780
Shipping Addresses

Same as Street Address
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH102910ActiveBPS-H80-005244KLAMATH HEALTH PARTNERSHIP, INCKlamath Open Door Family Practice2074 S 6th St Klamath FallsOR
CH10291AActiveBPS-H80-000776KLAMATH HEALTH PARTNERSHIP, INCCHILOQUIN OPEN DOOR FAMILY PRACTICE103 WASCO STREET CHILOQUINOR
CH10291CTerminatedBPS-H80-015260KLAMATH HEALTH PARTNERSHIP INCKlamath Open Door - Campus Clinic2684 CAMPUS DR KLAMATH FALLSOR
CH10291DActiveBPS-H80-024900KLAMATH HEALTH PARTNERSHIP, INCSBHC-Mazama High3009 Summers Ln Klamath FallsOR
CH10291ETerminatedBPS-H80-027269KLAMATH HEALTH PARTNERSHIP, INCKOD @ KBBH2210 N. Eldorado Ave. STE 1 Klamath FallsOR
CH10291FActiveBPS-H80-035264KLAMATH HEALTH PARTNERSHIP, INCPine Street Open Door403 Pine St Klamath FallsOR
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH102910ALBERTSONS LLCSAV-ON PHARMACY #577 5500 SOUTH 6TH STREET
KLAMATH FALLSOR9760301/01/2016  
CH10291DALBERTSONS LLCSAV-ON PHARMACY #577 5500 SOUTH 6TH STREET
KLAMATH FALLSOR9760301/01/2024  
CH102910HAGGEN OPCO NORTH, LLCHAGGEN PHARMACY #2122 2740 S 6TH
KLAMATH FALLSOR9760308/05/2015 09/30/2015
CH102910HAGGEN OPCO NORTH, LLCHAGGEN PHARMACY #2114 211 NORTH 8TH STREET
KLAMATH FALLSOR9760108/05/2015 09/30/2015
CH102910HEALTHY OPTIONS INCDBA POSTAL PRESCRIPTION SVCS 3500 SE 26TH AVE
PO BOX 2718 		PORTLANDOR9720207/01/2017  
CH102910MEYER2655 SHASTA WAY
KLAMATH FALLSOR9760304/01/2013  
CH10291FMEYER2655 SHASTA WAY
KLAMATH FALLSOR9760301/01/2024  
CH102910THRIFTY PAYLESS, INC.RITE AID #5388 2521 SOUTH SIXTH STREET
KLAMATH FALLSOR9760110/01/2013 04/23/2025
CH10291ETHRIFTY PAYLESS, INC.RITE AID #5388 2521 SOUTH SIXTH STREET
KLAMATH FALLSOR9760101/01/2024 04/01/2025
CH102910WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/01/2017  
CH102910WAL-MART PHARMACY 10-17723600 WASHBURN WAY
KLAMATH FALLSOR9760307/01/2014  
CH10291AWAL-MART PHARMACY 10-17723600 WASHBURN WAY
KLAMATH FALLSOR9760301/01/2024  
CH102910WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/01/2017  
CH102910WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275604/01/2023  
CH102910Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/5/2024 11:39:39 AM2/11/2025 12:22:15 PM2/11/2025 12:22 PM
ContactsAuthorizing OfficialUpdateChange RequestBland, Charles V. Chief Financial Officer Klamath Health Partnership, Inc. 8455416827Koch, Erich CEO Klamath Health Partnership 54181020401/21/2025 7:43 AM
DetailsEntity NameUpdateChange RequestKLAMATH HEALTH PARTNERSHIP INCKLAMATH HEALTH PARTNERSHIP, INC1/21/2025 7:43 AM
DetailsEntity SubnameUpdateChange RequestCHILOQUIN OPEN DOOR FAMILY PRAC.CHILOQUIN OPEN DOOR FAMILY PRACTICE1/21/2025 7:43 AM
Medicaid BillingNPI: NumberDeleteRecertification1538155825 (OR) 2/5/2024 11:39 AM
DetailsLast Recertification DateUpdateRecertification1/31/2023 2:35:47 PM2/5/2024 11:39:39 AM2/5/2024 11:39 AM
ContactsAuthorizing OfficialUpdateChange RequestPorter, Signe CFO Klamath Health Partnership Inc 5418518110-2022Bland, Charles V. Chief Financial Officer Klamath Health Partnership, Inc. 845541682712/28/2023 9:48 AM
ContactsAuthorizing OfficialUpdateProfile Change RequestPorter, Signe CFO Klamath Heaalth Partnership Inc 5418518110-2022Porter, Signe CFO Klamath Health Partnership Inc 5418518110-202210/10/2023 6:40 AM
ContactsPrimary ContactUpdateProfile Change RequestCox, Marcus CPO Klamath Health Partnership Inc 5418518110-8188Cox, Marcus Chief Pharmacy Officer Klamath Health Partnership, Inc 541887818810/10/2023 6:24 AM
DetailsLast Recertification DateUpdateRecertification2/17/2022 12:54:11 PM1/31/2023 2:35:47 PM1/31/2023 2:35 PM
ContactsPrimary ContactUpdateRecertificationArguello, Teri Finance Dept Manager Klamath Health Partnership Inc 5418818110-2088Cox, Marcus CPO Klamath Health Partnership Inc 5418518110-81882/17/2022 12:54 PM
DetailsLast Recertification DateUpdateRecertification2/26/2021 4:36:41 PM2/17/2022 12:54:11 PM2/17/2022 12:54 PM
Medicaid BillingNPI: NumberInsertRecertification 12252915032/26/2021 4:36 PM
Medicaid BillingNPI: StateInsertRecertification OR2/26/2021 4:36 PM
Medicaid BillingNPI: NumberInsertRecertification 15381558252/26/2021 4:36 PM
Medicaid BillingNPI: StateInsertRecertification OR2/26/2021 4:36 PM
Medicaid BillingNPI: NumberInsertRecertification 16890237802/26/2021 4:36 PM
Medicaid BillingNPI: StateInsertRecertification OR2/26/2021 4:36 PM
Medicaid BillingNPI: NumberDeleteRecertification1689023780 ( ) 2/26/2021 4:36 PM
Medicaid BillingNPI: NumberDeleteRecertification1538155825 ( ) 2/26/2021 4:36 PM
Medicaid BillingNPI: NumberDeleteRecertification1225291503 ( ) 2/26/2021 4:36 PM
DetailsLast Recertification DateUpdateRecertification2/12/2020 12:36:38 AM2/26/2021 4:36:41 PM2/26/2021 4:36 PM
DetailsLast Recertification DateUpdateRecertification2/4/2019 2:13:55 PM2/12/2020 12:36:38 AM2/12/2020 12:36 AM
Medicaid BillingNPI: NumberInsertRecertification 12252915032/4/2019 2:13 PM
ContactsPrimary ContactUpdateRecertificationJackson, Staci Finance Department Manager Klamath Health Partnership 5418802088Arguello, Teri Finance Dept Manager Klamath Health Partnership Inc 5418818110-20882/4/2019 2:13 PM
DetailsLast Recertification DateUpdateRecertification2/19/2018 1:30:20 PM2/4/2019 2:13:55 PM2/4/2019 2:13 PM
DetailsEntity NameUpdateRecertificationKLAMATH HEALTH PARTNERS INCKLAMATH HEALTH PARTNERSHIP INC2/4/2019 2:13 PM
DetailsLast Recertification DateUpdateRecertification2/21/2017 12:00:00 AM2/19/2018 1:30:20 PM2/19/2018 1:30 PM
ContactsPrimary ContactUpdateChange RequestPorter, Signe CFO Klamath Heaalth Partnership Inc 5418518110-2022Jackson, Staci Finance Department Manager Klamath Health Partnership 54188020881/30/2018 6:06 PM
ContactsAuthorizing OfficialUpdate Porter, Signe CFO 5418518110-2022Porter, Signe CFO Klamath Heaalth Partnership Inc 5418518110-202210/2/2017 11:42 PM
ContactsPrimary ContactUpdate Porter, Signe CFO 5418518110-2022Porter, Signe CFO Klamath Heaalth Partnership Inc 5418518110-202210/2/2017 11:42 PM
ContactsAuthorizing OfficialUpdate Ross, Bonnie CEO 5418818110-2021Porter, Signe CFO 5418518110-20227/13/2017 12:41 PM
ContactsPrimary ContactUpdate Ross, Bonnie CEO 5418818110-2021Porter, Signe CFO 5418518110-20227/13/2017 12:41 PM
AddressesMain AddressInsert   103 WASCO STREET CHILOQUIN, OR 976242/21/2017 9:52 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False2/21/2017 9:52 AM
Medicaid BillingMedicaid: NumberInsert  1700612/21/2017 9:52 AM
Medicaid BillingMedicaid: StateInsert  OR2/21/2017 9:52 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False2/21/2017 9:52 AM
Medicaid BillingMedicaid: NumberInsert  5007198982/21/2017 9:52 AM
Medicaid BillingMedicaid: StateInsert  OR2/21/2017 9:52 AM
Medicaid BillingNPI: NumberInsert  16890237802/21/2017 9:52 AM
Medicaid BillingNPI: NumberInsert  15381558252/21/2017 9:52 AM
DetailsLast Recertification DateUpdate 2/22/2016 12:00:00 AM2/21/2017 12:00:00 AM2/21/2017 9:52 AM
ContactsAuthorizing OfficialInsert  Ross, Bonnie CEO 5418818110-20212/22/2016 3:10 PM
ContactsPrimary ContactInsert  Ross, Bonnie CEO 5418818110-20212/22/2016 3:10 PM
DetailsLast Recertification DateUpdate 3/2/2015 12:00:00 AM2/22/2016 12:00:00 AM2/22/2016 3:10 PM
DetailsLast Recertification DateUpdate 2/18/2014 12:00:00 AM3/2/2015 12:00:00 AM3/2/2015 10:14 AM
DetailsEntity NameUpdate KLAMATH HEALTH PARTNERSHIP, INC.KLAMATH HEALTH PARTNERS INC3/31/2014 4:25 PM
DetailsEntity SubnameUpdate CHILOQUIN OPEN DOOR FAMILY PRACTICECHILOQUIN OPEN DOOR FAMILY PRAC.3/31/2014 4:25 PM
DetailsLast Recertification DateUpdate 4/1/2013 12:00:00 AM2/18/2014 12:00:00 AM2/18/2014 3:20 PM
DetailsLast Recertification DateUpdate  4/1/2013 12:00:00 AM2/15/2013 12:33 PM
AddressesBilling AddressInsert  KLAMATH HEALTH PARTNERSHIP, INC. 2074 SOUTH 6TH STREET KLAMATH FALLS, OR 9760112/22/2009 12:39 PM
DetailsLast Recertification DateInsert   12/22/2009 12:39 PM
DetailsGrant NumberInsert  H80CS0023312/22/2009 12:39 PM
Details340B IDInsert  CH10291A12/22/2009 12:39 PM
DetailsIs Authorizing Official EHB DataInsert   12/22/2009 12:39 PM
DatesLast Date That 340B Drugs PurchasedInsert   12/22/2009 12:39 PM
DetailsMedicare Provider NumberInsert   12/22/2009 12:39 PM
DetailsEntity NameInsert  KLAMATH HEALTH PARTNERSHIP, INC.12/22/2009 12:39 PM
DetailsProgram CodeInsert  CH12/22/2009 12:39 PM
DetailsEntity SubnameInsert  CHILOQUIN OPEN DOOR FAMILY PRACTICE12/22/2009 12:39 PM
DatesParticipating Approval DateInsert  11/10/2009 12:00:00 AM12/22/2009 12:39 PM
DetailsStateInsert  Active12/22/2009 12:39 PM
DatesRegistration DateInsert  11/10/2009 12:00:00 AM12/22/2009 12:39 PM
DatesSigned By DateInsert  9/22/2009 12:00:00 AM12/22/2009 12:39 PM
DatesStart DateInsert  1/1/2010 12:00:00 AM12/22/2009 12:39 PM
TerminationsTermination CommentsInsert   12/22/2009 12:39 PM
TerminationsTermination DateInsert   12/22/2009 12:39 PM
TerminationsTermination Effective DateInsert   12/22/2009 12:39 PM
TerminationsTermination ReasonInsert   12/22/2009 12:39 PM