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CH10766S CENTRAL CITY CONCERN (Active)
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Main Details
Name
CENTRAL CITY CONCERN
Subdivision Name
Hansen Clinic at Banfield Value Inn
Type
HRSA-Funded Health Center
Site ID
BPS-H80-031319
340B ID
CH10766S
Grant Number
H80CS00234
Additional Details
Current Program Status
Active
Registration Date
4/5/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/19/2018
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
1525 NE 37th Ave
Rm 38
Portland, OR 97232
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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