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CH10560D Mosaic Community Health (Active)
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Main Details
Name
Mosaic Community Health
Subdivision Name
Prineville Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000707
340B ID
CH10560D
Grant Number
H80CS00270
Additional Details
Current Program Status
Active
Registration Date
8/16/2006
Participating Start Date
10/1/2006
Participating Approval Date
8/23/2006
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
Mosaic Community Health
Steve Strang, CFO
(541) 788-6470
Primary Contact
Mosaic Medical
Robin Vallie, Pharmacy Operations Manager
(541) 383-3005
Addresses
Street Address
375 NW Beaver St Ste 101
Prineville, OR 97754-2003
Billing Address
Mosaic Medical
600 SW Columbia Street
Suite 6150
Bend, OR 97702
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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3/16/11 UPDATED ENTITY NAME (WAS OCHOCO HEALTH SYSTEMS), SUBDIV NAME (WAS MT. JEFFERSON COMMUNITY CLINIC)
03/16/2011
May 2025
May 2025
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