Contract Pharmacy Details

OREGON CVS PHARMACY, L.L.C.
STD97214 Cascade AIDS Project

Covered Entity Details

Entity Name

Cascade AIDS Project

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD97214

Entity Address

2236 SE Belmont Street
Portland, OR 97214

Grant Number

NU62PS924543

Participating Start Date

7/1/2017

Last Recertification Date

5/5/2025

Pharmacy Details

Pharmacy Name

OREGON CVS PHARMACY, L.L.C.

Pharmacy Address

CVS PHARMACY # 17640
939 SW MORRISON ST
PORTLAND, OR 97205

Pharmacy Comments

Contract Details

Approval Date

7/17/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Tyler A. TerMeer, Executive Director
(503) 278-3810

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/17/2018

340B Drug Pricing Program Database