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CH10112X COUNTY OF MULTNOMAH (Terminated)
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Main Details
Name
COUNTY OF MULTNOMAH
Subdivision Name
GEORGE MIDDLE SCHOOL STUDENT HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004403
340B ID
CH10112X
Grant Number
H80CS00149
Additional Details
Current Program Status
Terminated
Registration Date
4/4/2013
Participating Start Date
7/1/2013
Participating Approval Date
6/4/2013
Last Recertification Date
2/6/2019
Termination Date
Termination Reason
4/1/2020
Site closure
Contacts
Authorizing Official
Multnomah County
Mark Lewis, Administrator
(503) 988-7462
Primary Contact
Multnomah County
Rosalio Espinoza Zavala, Pharmacy Program Analyst
(503) 988-8852
Addresses
Street Address
10000 N Burr Ave
Portland, OR 97203-1714
Billing Address
GEORGE MIDDLE SCHOOL-BASED
619 NW 6th Ave.
Ste. 500
Portland, OR 97209
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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