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FQHC638552 COHO Benefits of Confederated Tribes of Siletz Indians (Terminated)
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Main Details
Name
COHO Benefits of Confederated Tribes of Siletz Indians
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638552
Additional Details
Current Program Status
Terminated
Registration Date
10/11/2018
Participating Start Date
1/1/2019
Participating Approval Date
10/26/2018
Last Recertification Date
2/5/2019
Termination Date
Termination Reason
1/1/2020
Never implemented the 340B Program
Contacts
Authorizing Official
Chinook Winds Casino Resort
Brad Darcy, Director
(541) 996-5882
Primary Contact
Confederated Tribes of Siletz Indians
Carmen F Riviello, Benefits Manager
(541) 996-5882
Addresses
Street Address
1777nw 44th street
lincoln city, OR 97367
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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May 2025
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