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CH05642AJ LAWNDALE CHRISTIAN HEALTH CENTER (Terminated)
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Main Details
Name
LAWNDALE CHRISTIAN HEALTH CENTER
Subdivision Name
Temporary Site - Ogden Shelter
Type
HRSA-Funded Health Center
Site ID
BPS-H80-037719
340B ID
CH05642AJ
Grant Number
H80CS00725
Additional Details
Current Program Status
Terminated
Registration Date
1/9/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/10/2024
Last Recertification Date
Termination Date
Termination Reason
1/1/2025
Site closure
Contacts
Authorizing Official
Lawndale Christian Health Center
Christopher Robert Dons, Chief Financial Officer
(872) 588-3032
Primary Contact
Lawndale Christian Health Center
Alexandra Cueto, Internal Auditor
(872) 588-3027
Addresses
Street Address
344 N Ogden Avenue
Chicago, IL 60607
Billing Address
LAWNDALE CHRISTIAN HLTH CTR
3860 WEST OGDEN AVENUE
CHICAGO, IL 60623
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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