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FQHC638492B Cow Creek Band of Umpqua Tribe of Indians (Approved)
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Main Details
Name
Cow Creek Band of Umpqua Tribe of Indians
Subdivision Name
Cow Creek Health & Wellness Center
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638492B
Additional Details
Current Program Status
Approved
Registration Date
4/3/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/2/2025
Last Recertification Date
Contacts
Authorizing Official
Cow Creek Band of Umpqua Tribe of Indians
Alicia A McAuley, Chief Operations Officer
(541) 580-5642
Primary Contact
Cow Creek Health & Wellness Center
Tamara Ann Robinson, Clinic Operations Coordinator
(541) 691-2433
Addresses
Street Address
480 Wartahoo Lane
Canyonville, OR 97417
Billing Address
Cow Creek Health & Wellness Center
2589 NW Edenbower Blvd
Roseburg, OR 97471
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date: (04/01/2013) until terminated effective date: (04/01/2019); reinstatement effective date: (07/1/2025)
04/30/2025
May 2025
May 2025
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