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LUNDGREN
CH107660 CENTRAL CITY CONCERN
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Covered Entity Details
Entity Name
CENTRAL CITY CONCERN
Subdivision Name
CENTRAL CITY CONCERN
Type
HRSA-Funded Health Center
340B ID
CH107660
Entity Address
232 NW 6th Ave
Portland, OR 97209-3609
Grant Number
H80CS00234
Participating Start Date
4/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
LUNDGREN
Pharmacy Address
DBA CENTRAL DRUG
538 SW 4TH
PORTLAND, OR 97204
Pharmacy Comments
Contract Details
Approval Date
8/19/2004
Contract Begin Date
8/19/2004
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/10/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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