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HAGGEN OPCO NORTH, LLC
CH102910 KLAMATH HEALTH PARTNERSHIP, INC
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Covered Entity Details
Entity Name
KLAMATH HEALTH PARTNERSHIP, INC
Subdivision Name
Klamath Open Door Family Practice
Type
HRSA-Funded Health Center
340B ID
CH102910
Entity Address
2074 S 6th St
Klamath Falls, OR 97601-3372
Grant Number
H80CS00233
Participating Start Date
4/1/2001
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HAGGEN OPCO NORTH, LLC
Pharmacy Address
HAGGEN PHARMACY #2122
2740 S 6TH
KLAMATH FALLS, OR 97603
Pharmacy Comments
Contract Details
Approval Date
8/3/2015
Contract Begin Date
8/5/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2015
Pharmacy closed
Contacts
Covered Entity Signing Official
Signe Porter, CFO
(541) 851-8110 Ext: 2022
Contract Pharmacy Representative
Mike Arndorfer, Pharmacy Vice President
(360) 650-8210
Signed By Date
8/3/2015
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