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HOMETOWN DRUGS OF ROSEBURG INC
CH10310B 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
ROSEBURG HIGH SCHOOL
Type
HRSA-Funded Health Center
340B ID
CH10310B
Entity Address
400 W Harvard Ave
Roseburg, OR 97470-3012
Grant Number
H80CS00567
Participating Start Date
10/1/2007
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
HOMETOWN DRUGS OF ROSEBURG INC
Pharmacy Address
1813 W HARVARD STREET
SUITE 210
ROSEBURG, OR 97471
Pharmacy Comments
Contract Details
Approval Date
2/24/2009
Contract Begin Date
2/24/2009
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
2/6/2009
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