340B Drug Pricing Program Database
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DSH380007 LEGACY EMANUEL HOSPITAL & HEALTH CENTER (Active)
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Main Details
Name
LEGACY EMANUEL HOSPITAL & HEALTH CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH380007
Medicare Provider Number
380007
Additional Details
Current Program Status
Active
Registration Date
6/15/2007
Participating Start Date
7/1/2007
Participating Approval Date
6/15/2007
Last Recertification Date
9/2/2024
Contacts
Authorizing Official
Legacy Health
Kecia Kelly, SVP Chief Nursing Officer
(503) 415-5199
Primary Contact
Legacy Health
Elena Valcarlos, Pharmacy Systems Manager
(503) 413-7764
Addresses
Street Address
2801 N GANTENBEIN AVE
PORTLAND, OR 97227
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/16/10 ENTITY NAME CHANGE (WAS LEGACY EMANUEL HOSPITAL AND HEALTH CENTER)
06/15/2007
May 2025
May 2025
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