340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PHOENIX DOWNTOWN PHARMACY, LLC
CH100790 LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC
Print
Covered Entity Details
Entity Name
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC
Subdivision Name
PHOENIX HEALTH CENTER--LA CLINICA
Type
HRSA-Funded Health Center
340B ID
CH100790
Entity Address
3617 S Pacific Hwy
Medford, OR 97501-8957
Grant Number
H80CS00759
Participating Start Date
1/1/1999
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PHOENIX DOWNTOWN PHARMACY, LLC
Pharmacy Address
404 N. MAIN ST
PHOENIX, OR 97535-9632
Pharmacy Comments
Contract Details
Approval Date
12/6/2013
Contract Begin Date
12/6/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/10/2017
Pharmacy closed
Contacts
Covered Entity Signing Official
Brenda Johnson, CEO
(541) 512-3151
Contract Pharmacy Representative
Ben Egendoerfer, Owner
(541) 535-1561
Signed By Date
11/26/2013
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session