340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH380038A PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER (Active)
Print
Main Details
Name
PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER
Subdivision Name
OUTPATIENT INFUSION CLINIC - OUTPATIENT INFUSIONS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH380038A
Medicare Provider Number
380038
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/13/2020
Participating Start Date
7/1/2020
Participating Approval Date
5/22/2020
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Providence Willamette Falls Medical Center
Brad Walker Henry, Chief Executive
(503) 657-6915
Primary Contact
Providence Health and Services
Mac Ovenell, 340B Director
(509) 860-8643
Addresses
Street Address
1510 Division Street
SUITE 130
OREGON CITY, OR 97045
Billing Address
PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER
1500 DIVISION STREET
OREGON CITY, OR 97045
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session