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ST. CHARLES HEALTH SYSTEM, INC.
CH105600 Mosaic Community Health
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Covered Entity Details
Entity Name
Mosaic Community Health
Subdivision Name
Madras Health Center
Type
HRSA-Funded Health Center
340B ID
CH105600
Entity Address
500 NE A St Ste 100
Madras, OR 97741
Grant Number
H80CS00270
Participating Start Date
10/1/2003
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
ST. CHARLES HEALTH SYSTEM, INC.
Pharmacy Address
DBA: ST. CHARLES BEND CAMPUS COMMUNITY P
2500 NE NEFF RD
BEND, OR 97701
Pharmacy Comments
Contract Details
Approval Date
4/12/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Albert Noyes, Director of Retail Pharmacy
(541) 447-0707 Ext: 7060
Contract Pharmacy Representative
St. Charles Health System
John Miller, Pharmacy Manager
(541) 382-4321 Ext: 4748
Signed By Date
4/12/2019
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