340B Drug Pricing Program Database


DSH380007K LEGACY EMANUEL MEDICAL CENTER (Terminated) - information as of 5/10/2025 11:02:59 PM

Main Details
LEGACY EMANUEL MEDICAL CENTER
LEMC Podiatry
Disproportionate Share Hospital
No
DSH380007K
380007


Additional Details
Terminated
10/11/2016
1/1/2017
10/26/2016

7/1/2017
Site closure

Contacts

Legacy Health
Anna Loomis, SVP Chief Financial Officer
(503) 415-5730

Legacy Health
Kathleen C. Stoner, Vice President Supply Chain and Pharmacy Services
(503) 944-4276

Addresses

2800 N Vancouver Ste 130
Portland, OR 97227-1668

Legacy Emanuel Medical Center
2801 N Gantenbein Ave.
Portland, OR 97227


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Legacy Emanuel Medical Center
2801 N Gantenbein Ave.
Portland, OR 97227
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH380007BChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Magnetic Resonance Imaging / MRI 150-3523501 N Graham StPortlandORActive
DSH380007CChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Rehabilitation / OP Rehab 150-3669300 N Graham StPortlandORActive
DSH380007DChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Medication Management Services / Legacy Medication Mgmt Service 150-3719501 N Graham StPortlandORActive
DSH380007EChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Wound Care Center / Chronic Wound Care Center 150-21653001 N Gantenbein AvePortlandORActive
DSH380007FChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Day Treatment Unit / Day Treatment Clinics 150-3552501 N Graham StPortlandORActive
DSH380007GChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Medical Group Internal Medicine Emanuel / LMG Emanuel IM 155-39062800 N Vancouver AvePortlandORActive
DSH380007HChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Medical Group Broadway / LMG Broadway 155-83601600 NE BROADWAY STPORTLANDORActive
DSH380007JChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Medical Group Northeast / LMG Northeast 155-8030300 N Graham StPortlandORActive
DSH380007KChildDSHLEGACY EMANUEL MEDICAL CENTERLEMC Podiatry2800 N Vancouver Ste 130PortlandORTerminated
DSH380007LChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Medical Group Gynecology Emanuel / LMG Emanuel IM Gynecology 155-39062800 N Vancouver AvePortlandORActive
DSH380007MChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Occupational Therapy - Wound Care Center / OP Rehab 150-36693001 N Gantenbein AvePortlandORActive
DSH380007NChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERUnity Center for Behavioral Health Emergency Department - A Service of Legacy Emanuel - Unity Center for Behavioral Health Emergency Department1225 NE 2ND AVEPORTLANDORTerminated
DSH380007PChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Bone Clinic / Chronic Wound Care Center 150-21653001 N Gantenbein AvePortlandORActive
DSH380007QChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Devers Eye Institute / Devers Eye Clinic 150-3903300 N Graham StPortlandORActive
DSH380007RChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Hyperbaric Program / Hyperbaric Medicine 150-21683001 N Gantenbein AvePortlandORActive
DSH380007SChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Cardiopulmonary / Respiratory Therapy 150-3110501 N Graham StPortlandORActive
DSH380007TChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Trauma NeuroTrauma Clinic - Trauma Clinic 150-2269300 N Graham StPortlandORTerminated
DSH380007UChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Cardiac Rehabilitation / Cardiac Rehab 150-3440501 N Graham StPortlandORActive
DSH380007VChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Infusion Services IV Clinic / IV Therapy 150-3716501 N Graham StPortlandORActive
DSH380007WChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERLegacy Emanuel Radiation Oncology / Radiology Diagnostic 150-3512450 N Graham StPortlandORTerminated
DSH380007XChildDSHLEGACY EMANUEL HOSPITAL & HEALTH CENTERUBH PES Center for Behavioral Health Emergency Department - Psychiatric Emergency Services 170-32801225 NE 2nd AvePortlandORActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsAuthorizing OfficialUpdateChange RequestBradley, Carol SVP and Chief Nursing Officer Legacy Health 5034155199Loomis, Anna SVP Chief Financial Officer Legacy Health 50341557309/16/2019 5:17 AM
ContactsAuthorizing OfficialUpdateChange RequestNewcomb III, Everett W. Sr Vice President and COO Legacy Health 5034155252Bradley, Carol SVP and Chief Nursing Officer Legacy Health 503415519912/19/2018 12:49 PM
ContactsPrimary ContactUpdateProfile Change RequestStoner, Kathleen C. Director, LH Pharmacy Services Legacy Health 5034136926Stoner, Kathleen C. Vice President Supply Chain and Pharmacy Services Legacy Health 50394442769/7/2018 1:25 PM
ContactsAuthorizing OfficialUpdate Newcomb III, Everett W. Sr Vice President and COO 5034155252Newcomb III, Everett W. Sr Vice President and COO Legacy Health 503415525210/11/2017 1:31 PM
ContactsSigned ByUpdate Newcomb III, Everett W. Sr Vice President and COO 5034155252Newcomb III, Everett W. Sr Vice President and COO Legacy Health 503415525210/11/2017 1:31 PM
ContactsPrimary ContactUpdate Stoner, Kathleen C. Director, LH Pharmacy Services 5034136926Stoner, Kathleen C. Director, LH Pharmacy Services Legacy Health 503413692610/11/2017 12:40 PM
ContactsPrimary ContactInsert  Stoner, Kathleen C. Director, LH Pharmacy Services 50341369266/12/2017 2:32 PM
ContactsAuthorizing OfficialInsert  Newcomb III, Everett W. Sr Vice President and COO 50341552526/12/2017 2:32 PM
ContactsSigned ByInsert  Newcomb III, Everett W. Sr Vice President and COO 50341552526/12/2017 2:32 PM
AddressesMain AddressInsert   2800 N Vancouver Ste 130 Portland, OR 97227-16686/6/2017 10:35 AM
AddressesBilling AddressInsert  Legacy Emanuel Medical Center 2801 N Gantenbein Ave. Portland, OR 972276/6/2017 10:35 AM
AddressesShipping AddressInsert  Legacy Emanuel Medical Center 2801 N Gantenbein Ave. Portland, OR 972276/6/2017 10:35 AM
DatesLast Date That 340B Drugs PurchasedUpdate  5/31/2017 12:00:00 AM6/6/2017 10:34 AM
DetailsStateUpdate ActiveTerminated6/6/2017 10:34 AM
TerminationsTermination CommentsUpdate  Site no longer bills for drugs.6/6/2017 10:34 AM
TerminationsTermination DateUpdate  7/1/2017 12:00:00 AM6/6/2017 10:34 AM
TerminationsTermination Effective DateUpdate  5/31/2017 12:00:00 AM6/6/2017 10:34 AM
TerminationsTermination ReasonUpdate  Site closure6/6/2017 10:34 AM
DatesParticipating Approval DateUpdate  10/26/2016 12:00:00 AM10/26/2016 6:01 PM
DetailsStateUpdate PendingActive10/26/2016 6:01 PM
DatesStart DateUpdate  1/1/2017 12:00:00 AM10/26/2016 6:01 PM
Details340B IDUpdate OUTPATIENT_ONLINE_REG_72869DSH380007K10/12/2016 9:32 AM
Details340B IDUpdate  OUTPATIENT_ONLINE_REG_7286910/11/2016 3:37 PM
DetailsLast Recertification DateInsert   10/11/2016 3:37 PM
DetailsGrant NumberInsert   10/11/2016 3:37 PM
Details340B IDInsert   10/11/2016 3:37 PM
DetailsIs Authorizing Official EHB DataInsert   10/11/2016 3:37 PM
DatesLast Date That 340B Drugs PurchasedInsert   10/11/2016 3:37 PM
DetailsMedicare Provider NumberInsert  38000710/11/2016 3:37 PM
DetailsEntity NameInsert  LEGACY EMANUEL MEDICAL CENTER10/11/2016 3:37 PM
DetailsProgram CodeInsert  DSH10/11/2016 3:37 PM
DetailsEntity SubnameInsert  LEMC Podiatry10/11/2016 3:37 PM
DatesParticipating Approval DateInsert   10/11/2016 3:37 PM
DetailsStateInsert  Pending10/11/2016 3:37 PM
DatesRegistration DateInsert  10/11/2016 12:00:00 AM10/11/2016 3:37 PM
DatesSigned By DateInsert  10/11/2016 12:00:00 AM10/11/2016 3:37 PM
DatesStart DateInsert   10/11/2016 3:37 PM
TerminationsTermination CommentsInsert   10/11/2016 3:37 PM
TerminationsTermination DateInsert   10/11/2016 3:37 PM
TerminationsTermination Effective DateInsert   10/11/2016 3:37 PM
TerminationsTermination ReasonInsert   10/11/2016 3:37 PM