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CH10766P CENTRAL CITY CONCERN (Active)
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Main Details
Name
CENTRAL CITY CONCERN
Subdivision Name
Puentes
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017528
340B ID
CH10766P
Grant Number
H80CS00234
Additional Details
Current Program Status
Active
Registration Date
7/8/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/15/2016
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Central City Concern
Andrew Mendenhall, CEO
(503) 294-1681
Primary Contact
Central City Concern
Chris Lagor, Compliance Manager
(971) 361-7769
Addresses
Street Address
12672 SE Stark St Ste 12672
Portland, OR 97233
Billing Address
Central City Concern
232 NW 6th Ave
PORTLAND, OR 97209
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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