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PHARMBLUE OREGON LLC
RWII97403 HIV Alliance
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Covered Entity Details
Entity Name
HIV Alliance
Subdivision Name
Type
Ryan White Part B
340B ID
RWII97403
Entity Address
1195 A City View Street
Eugene, OR 97402
Grant Number
X07HA00007
Participating Start Date
10/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PHARMBLUE OREGON LLC
Pharmacy Address
140 S HOLLY ST
SUITE 1131
MEDFORD, OR 97501-3113
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Renee Yandel, Executive Director
(541) 342-5088 Ext: 118
Contract Pharmacy Representative
PharmBlue, LLC
Joseph P. Pohl III, CEO
(724) 779-4720 Ext: 033
Signed By Date
1/11/2018
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