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CREDENA HEALTH PHARMACY ST VINCENT
CHC24160-00 Neighborhood Health Center
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Covered Entity Details
Entity Name
Neighborhood Health Center
Subdivision Name
NHC Administration and Pharmacy
Type
HRSA-Funded Health Center
340B ID
CHC24160-00
Entity Address
7320 SW Hunziker Rd STE 300
Portland, OR 97223
Grant Number
H80CS24160
Participating Start Date
1/1/2015
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
CREDENA HEALTH PHARMACY ST VINCENT
Pharmacy Address
9155 SW BARNES RD STE 102
PORTLAND, OR 97225-6625
Pharmacy Comments
Contract Details
Approval Date
4/12/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Blain A. West, CFO / COO
(503) 941-3028
Contract Pharmacy Representative
Providence St. Joseph Health
Glenn W Wachter, Outpatient Ops Strat Exec Dir, Pharmacy
(503) 962-1743
Signed By Date
4/12/2019
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