340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LEGACY MT. HOOD MEDICAL CENTER PHARMACY
DSH380029 SILVERTON HEALTH DBA LEGACY SILVERTON MEDICAL CENTER OR SILVERTON HEALTH
Print
Covered Entity Details
Entity Name
SILVERTON HEALTH DBA LEGACY SILVERTON MEDICAL CENTER OR SILVERTON HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH380029
Entity Address
342 FAIRVIEW STREET
SILVERTON, OR 97381-1993
Medicare Provider Number
380029
Participating Start Date
1/1/2019
Last Recertification Date
9/2/2024
Pharmacy Details
Pharmacy Name
LEGACY MT. HOOD MEDICAL CENTER PHARMACY
Pharmacy Address
24800 SE STARK ST
GRESHAM, OR 97030-3378
Pharmacy Comments
Contract Details
Approval Date
1/14/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Majid Tanas, VP Pharmacy Services
(503) 415-5011
Contract Pharmacy Representative
Legacy Health
Elena Valcarlos, Pharmacy Systems Manager
(503) 413-7764
Signed By Date
1/14/2022
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