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OREGON CVS PHARMACY, L.L.C.
CH10792N COUNTY OF LANE
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Covered Entity Details
Entity Name
COUNTY OF LANE
Subdivision Name
Brookside Clinic
Type
HRSA-Funded Health Center
340B ID
CH10792N
Entity Address
1680 Chambers Street STE 103
Eugene, OR 97402-3655
Grant Number
H80CS01443
Participating Start Date
1/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
OREGON CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 16158
2750 GATEWAY ST
SPRINGFIELD, OR 97477
Pharmacy Comments
Contract Details
Approval Date
7/12/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eve Gray, H&HS Director
(541) 682-3942
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/12/2023
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