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CH10792N COUNTY OF LANE (Active)
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Main Details
Name
COUNTY OF LANE
Subdivision Name
Brookside Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013927
340B ID
CH10792N
Grant Number
H80CS01443
Additional Details
Current Program Status
Active
Registration Date
10/1/2014
Participating Start Date
1/1/2015
Participating Approval Date
10/9/2014
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Lane County
Eve Gray, H&HS Director
(541) 682-3942
Primary Contact
County of Lane
Juan Rivera, Program Services Coordinator II
(541) 731-4439
Addresses
Street Address
1680 Chambers Street STE 103
Eugene, OR 97402-3655
Billing Address
Riverside Clinic/CFS
2073 Olympic Street
Springfield, OR 97477-3413
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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