340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CREDENA HEALTH PHARMACY ST VINCENT
RWIID97232 Oregon Health Authority
Print
Covered Entity Details
Entity Name
Oregon Health Authority
Subdivision Name
ADAP / CAREAssist
Type
Ryan White Part B ADAP Direct Purchase
340B ID
RWIID97232
Entity Address
800 NE Oregon St.
Suite 1105
Portland, OR 97232
Grant Number
X07HA00007
Participating Start Date
10/1/2011
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
CREDENA HEALTH PHARMACY ST VINCENT
Pharmacy Address
9155 SW BARNES RD STE 102
PORTLAND, OR 97225-6625
Pharmacy Comments
Contract Details
Approval Date
6/9/2021
Contract Begin Date
6/9/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Annick Julia Benson-Scott, HIV/STD/TB Section Manager
(971) 673-0142
Contract Pharmacy Representative
Credena Health
Tavis Smith, Manager
(971) 236-8596
Signed By Date
6/9/2021
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