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PROCARE PHARMACY, L.L.C.
CH10112AE MULTNOMAH COUNTY
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Covered Entity Details
Entity Name
MULTNOMAH COUNTY
Subdivision Name
HIV Health Services Center
Type
HRSA-Funded Health Center
340B ID
CH10112AE
Entity Address
619 NW 6th Ave.
3rd Floor
PORTLAND, OR 97209
Grant Number
H80CS00149
Participating Start Date
7/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2819
1309 NW 23RD AVE.
PORTLAND, OR 97210
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jeff Perry, Finance Officer
(503) 679-6544
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2021
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