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DSH380009A OREGON HLTH SCIENCE CENTER (Terminated)
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Main Details
Name
OREGON HLTH SCIENCE CENTER
Subdivision Name
OHSU GABRIEL PARK
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH380009A
Medicare Provider Number
380009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
11/16/2006
Participating Start Date
7/1/2005
Participating Approval Date
11/16/2006
Last Recertification Date
8/21/2023
Termination Date
Termination Reason
10/1/2024
Other
Contacts
Authorizing Official
OHSU
Joe E Ness, SVP and Chief Operating Officer
(503) 720-7616
Primary Contact
OHSU
Jennifer Zanon, Director Pharmacy Services; Regulatory Compliance
(503) 418-1286
Addresses
Street Address
4411 SW Vermont st
Portland, OR 97219
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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