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CH10766E CENTRAL CITY CONCERN (Terminated)
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Main Details
Name
CENTRAL CITY CONCERN
Subdivision Name
CEP CONSUMER CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001839
340B ID
CH10766E
Grant Number
H80CS00234
Additional Details
Current Program Status
Terminated
Registration Date
4/1/2004
Participating Start Date
4/1/2004
Participating Approval Date
8/24/2004
Last Recertification Date
1/31/2022
Termination Date
Termination Reason
4/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Central City Concern
Andrew Mendenhall, CEO
(503) 294-1681
Primary Contact
Central City Concern
Chris Lagor, Compliance Manager
(971) 361-7769
Addresses
Street Address
610 NW Davis St
Portland, OR 97209-3617
Billing Address
CENTRAL CITY CONCERN
232 NW 6TH AVE
PORTLAND, OR 97209
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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9/6/07- SUB-DIVISION AND ADDRESS CHANGE--PREVIOUS SUB-DIVISION NAME- CEP PROGRAM & PREVIOUS ADD-707 NW EVERETT STREET; NEW SITE 04/01/2004
09/06/2007
April 2025
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