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CH10112AH COUNTY OF MULTNOMAH (Terminated)
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Main Details
Name
COUNTY OF MULTNOMAH
Subdivision Name
HARRISON PARK K-8 STUDENT HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004653
340B ID
CH10112AH
Grant Number
H80CS00149
Additional Details
Current Program Status
Terminated
Registration Date
10/1/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/7/2013
Last Recertification Date
2/12/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
Multnomah County
Mark Lewis, Administrator
(503) 988-7462
Primary Contact
Multnomah County
CAMMY GADDIS, Finance Specialist
(503) 988-7468
Addresses
Street Address
2225 SE 87th Ave
Portland, OR 97216-2006
Billing Address
Harrison Park SBHC
421 SW Oak St.
Ste. 210
Portland, OR 97204
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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