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CH10123P VIRGINIA GARCIA MEMORIAL HEALTH CENTER (Terminated)
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Main Details
Name
VIRGINIA GARCIA MEMORIAL HEALTH CENTER
Subdivision Name
Tualatin School Based Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014738
340B ID
CH10123P
Grant Number
H80CS00817
Additional Details
Current Program Status
Terminated
Registration Date
2/14/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/24/2017
Last Recertification Date
1/29/2019
Termination Date
Termination Reason
1/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Virginia Garcia Memorial Health Center
Annmarie Rainford Dennis, Corporate Compliance Officer
(503) 214-1652
Primary Contact
Virginia Garcia Memorial Health Center
Christine Hicks, Pharmacy Director
(503) 352-8553
Addresses
Street Address
22300 SW BOONES FERRY RD
TUALATIN, OR 97062-7373
Billing Address
Virginia Garcia Memorial Health Center - Tualatin School Based Health Center
PO Box 6149
Aloha, OR 97007
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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