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DSH380009AA OREGON HLTH SCIENCE CENTER (Active)
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Main Details
Name
OREGON HLTH SCIENCE CENTER
Subdivision Name
Internal Medicine Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH380009AA
Medicare Provider Number
380009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/8/2014
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
OHSU
Joe E Ness, SVP and Chief Operating Officer
(503) 720-7616
Primary Contact
OHSU
Jennifer Zanon, Director Pharmacy Services; Regulatory Compliance
(503) 418-1286
Addresses
Street Address
3270 SW Pavilion Loop
Portland, OR 97239
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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