Contract Pharmacy Details

HOME TOWN DRUGS OF PRINEVILLE, INC
CH105600 Mosaic Community Health

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

HOME TOWN DRUGS OF PRINEVILLE, INC

Pharmacy Address

DBA: CLINIC PHARMACY
198 NE COMBS FLAT RD, STE. 100
PRINEVILLE, OR 97754

Pharmacy Comments

Contract Details

Approval Date

12/28/2005

Contract Begin Date

12/28/2005

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

12/9/2005

340B Drug Pricing Program Database