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CH10310M Umpqua Community Health Center, Inc. (Terminated)
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Main Details
Name
Umpqua Community Health Center, Inc.
Subdivision Name
Aviva Health Newton Creek Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-032346
340B ID
CH10310M
Grant Number
H80CS00567
Additional Details
Current Program Status
Terminated
Registration Date
6/16/2021
Participating Start Date
6/17/2021
Participating Approval Date
6/17/2021
Last Recertification Date
2/1/2022
Termination Date
Termination Reason
10/1/2022
Site closure
Contacts
Authorizing Official
Umpqua Community Health Center, Inc., dba Aviva Health
Leah Woods, Chief Financial Officer
(541) 672-9596 Ext: 120
Primary Contact
Umpqua Community Health Center
Shannon Davis, 340B Program Manager
(541) 672-9596 Ext: 403
Addresses
Street Address
3031 NE Stephens St. STE 600, 900
Roseburg, OR 97470-6237
Billing Address
Umpqua Community Health Center, Inc., dba Aviva Health
150 NE Kenneth Ford Dr
Roseburg, OR 97470
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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