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CH10070B WHITE BIRD CLINIC (Terminated)
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Main Details
Name
WHITE BIRD CLINIC
Subdivision Name
Chrysalis Behavioral Health
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012012
340B ID
CH10070B
Grant Number
H80CS00055
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/25/2018
Last Recertification Date
2/27/2023
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
White Bird Clinic
Ian Strauss, Interim Special Projects Coordinator
(541) 913-3879
Primary Contact
White Bird Clinic
Julie Christensen, Medical Clinic Operations Guru
(541) 484-4800
Addresses
Street Address
350 E 11th Ave
Eugene, OR 97401-3246
Billing Address
White Bird Clinic
341 East 12th
Eugene, OR 97401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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