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APOLLO PHARMACY GROUP, INC.
CH103100 UMPQUA COMMUNITY HEALTH CENTER, INC., dba Aviva Health
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Covered Entity Details
Entity Name
UMPQUA COMMUNITY HEALTH CENTER, INC., dba Aviva Health
Subdivision Name
Umpqua Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH103100
Entity Address
150 NE Kenneth Ford Drive
Roseburg, OR 97470
Grant Number
H80CS00567
Participating Start Date
10/1/2003
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
APOLLO PHARMACY GROUP, INC.
Pharmacy Address
DBA SUTHERLIN DRUG
113 E. CENTRAL AVE.
SUTHERLIN, OR 97479
Pharmacy Comments
Contract Details
Approval Date
8/18/2023
Contract Begin Date
8/18/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Leah Woods, Chief Financial Officer
(541) 672-9596 Ext: 120
Contract Pharmacy Representative
Apollo Pharmacy Group
Allen B Reece, PIC
(541) 459-2712
Signed By Date
8/18/2023
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