340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PEACEHEALTH RIVERBEND OUTPATIENT PHARMAC
CAH381316-00 PeaceHealth DBA Peace Harbor Medical Center
Print
Covered Entity Details
Entity Name
PeaceHealth DBA Peace Harbor Medical Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH381316-00
Entity Address
400 9TH STREET
Attention Pharmacy Services Department
FLORENCE, OR 97439
Medicare Provider Number
381316
Participating Start Date
1/1/2011
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
PEACEHEALTH RIVERBEND OUTPATIENT PHARMAC
Pharmacy Address
PEACEHEALTH RIVERBEND OUTPATIENT PHARMAC
3333 RIVERBEND DR
SPRINGFIELD, OR 97477
Pharmacy Comments
03/06/2014 - Pharmacy name and address correction, changed in error on 3/28/2013, see history for details.
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jason Hawkins, Chief Administrive Officer
(541) 902-6540
Contract Pharmacy Representative
Peacehealth Employee Benefits Pharmacy
Vestalee Shrader, Pharmacist Manager
(541) 984-2185
Signed By Date
4/15/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session