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FRED MEYER STORES INC
CHC24160-12 Neighborhood Health Center
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Covered Entity Details
Entity Name
Neighborhood Health Center
Subdivision Name
NHC Oregon City Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CHC24160-12
Entity Address
728 Molalla Ave
Oregon City, OR 97045-2799
Grant Number
H80CS24160
Participating Start Date
4/1/2020
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
FRED MEYER STORES INC
Pharmacy Address
FRED MEYER PHARMACY #651
1401 SE FIRST AVE
CANBY, OR 97013
Pharmacy Comments
Contract Details
Approval Date
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Blain A. West, CFO / COO
(503) 941-3028
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/14/2024
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