340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FRED MEYER
DSH380007 LEGACY EMANUEL HOSPITAL & HEALTH CENTER
Print
Covered Entity Details
Entity Name
LEGACY EMANUEL HOSPITAL & HEALTH CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH380007
Entity Address
2801 N GANTENBEIN AVE
PORTLAND, OR 97227
Medicare Provider Number
380007
Participating Start Date
7/1/2007
Last Recertification Date
9/2/2024
Pharmacy Details
Pharmacy Name
FRED MEYER
Pharmacy Address
7404 N. INTERSTATE AVE
PORTLAND, OR 97217
Pharmacy Comments
Contract Details
Approval Date
7/26/2012
Contract Begin Date
7/26/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/25/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David E. Eager, Sr. VP and CFO, Legacy Health
(503) 415-5730
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
7/20/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session