Contract Pharmacy Details

HOMETOWN DRUGS OF ROSEBURG INC
CH10310F UMPQUA COMMUNITY HEALTH CENTER, INC., dba Aviva Health

Covered Entity Details

Entity Name

UMPQUA COMMUNITY HEALTH CENTER, INC., dba Aviva Health

Subdivision Name

Myrtle Creek Clinic

Type

HRSA-Funded Health Center

340B ID

CH10310F

Entity Address

790 S Main St
Myrtle Creek, OR 97457-9303

Grant Number

H80CS00567

Participating Start Date

4/1/2009

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

4/1/2009

Contract Begin Date

4/1/2009

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

2/13/2009

340B Drug Pricing Program Database