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CH10560Y Mosaic Community Health (Active)
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Main Details
Name
Mosaic Community Health
Subdivision Name
Kingwood Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-036869
340B ID
CH10560Y
Grant Number
H80CS00270
Additional Details
Current Program Status
Active
Registration Date
4/15/2022
Participating Start Date
7/1/2022
Participating Approval Date
4/20/2022
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
Mosaic Community Health
Steve Strang, CFO
(541) 788-6470
Primary Contact
Mosaic Medical
Robin Vallie, Pharmacy Operations Manager
(541) 383-3005
Addresses
Street Address
244 NW Kingwood Avenue
Redmond, OR 97756-1812
Billing Address
Mosaic Medical
600 SW Columbia Street Ste 6150
Bend, OR 97702
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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