Contract Pharmacy Details

FRED MEYER INC
CH10792N COUNTY OF LANE

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

FRED MEYER INC

Pharmacy Address

3333 W 11TH AVENUE
EUGENE, OR 97402

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

Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672

Signed By Date

7/12/2023

340B Drug Pricing Program Database