340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AVITA DRUGS OREGON LLC
FQHCLA405A Cascade Aids Project
Print
Covered Entity Details
Entity Name
Cascade Aids Project
Subdivision Name
Cascade AIDS Project
Type
Health Center Program Look-Alike
340B ID
FQHCLA405A
Entity Address
520 NW Davis St Ste 215
Portland, OR 97209-3620
Grant Number
LALCS33965
Participating Start Date
7/1/2020
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
AVITA DRUGS OREGON LLC
Pharmacy Address
DBA: AVITA PHARMACY 1027
2236 SE BELMONT ST STE A
PORTLAND, OR 97214-2817
Pharmacy Comments
Contract Details
Approval Date
4/8/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tyler A. TerMeer, Executive Director
(503) 278-3810
Contract Pharmacy Representative
AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
Signed By Date
4/8/2020
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