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CREDENA HEALTH LLC
RWIID97232 Oregon Health Authority
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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 LLC
Pharmacy Address
7376 SW DURHAM RD
PORTLAND, OR 97224
Pharmacy Comments
Contract Details
Approval Date
10/7/2022
Contract Begin Date
1/1/2023
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
10/7/2022
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