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OREGON CVS PHARMACY, L.L.C.
CH101030 YAKIMA VALLEY FARM WORKERS CLINIC
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Covered Entity Details
Entity Name
YAKIMA VALLEY FARM WORKERS CLINIC
Subdivision Name
YVFWC - TOPPENISH
Type
HRSA-Funded Health Center
340B ID
CH101030
Entity Address
510 W 1st Ave
Toppenish, WA 98948-1564
Grant Number
H80CS00639
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
OREGON CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 17195
6450 KEIZER STATION BLVD NE
KEIZER, OR 97303
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Christine Sue Trotter, CEO
(509) 865-6175 Ext: 2128
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2022
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