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WALGREEN CO.
CH101310 CLACKAMAS, COUNTY OF
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Covered Entity Details
Entity Name
CLACKAMAS, COUNTY OF
Subdivision Name
Clackamas Health Centers Administration
Type
HRSA-Funded Health Center
340B ID
CH101310
Entity Address
2051 Kaen Road STE 367
Oregon City, OR 97045-4035
Grant Number
H80CS00547
Participating Start Date
4/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01100
9159 SE 82ND AVE
HAPPY VALLEY, OR 97086
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Deborah Cockrell, FQHC Director
(503) 742-5495
Contract Pharmacy Representative
Walgreens
Hiroshi Vo, Analyst
(847) 964-8743
Signed By Date
1/11/2018
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