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CH10766K CENTRAL CITY CONCERN (Terminated)
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Main Details
Name
CENTRAL CITY CONCERN
Subdivision Name
CCC Recovery Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001124
340B ID
CH10766K
Grant Number
H80CS00234
Additional Details
Current Program Status
Terminated
Registration Date
9/6/2007
Participating Start Date
10/1/2007
Participating Approval Date
9/8/2007
Last Recertification Date
1/30/2023
Termination Date
Termination Reason
1/1/2024
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
726 W Burnside St
Portland, OR 97209-3515
Billing Address
CENTRAL CITY CONCERN
232 NW 6TH AVENUE
PORTLAND, OR 97209
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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