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FQHCLA458F INTERCOMMUNITY INC (Active)
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Main Details
Name
INTERCOMMUNITY INC
Subdivision Name
InterCommunity's School Based Health Center at Silver Lane School
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-020933
340B ID
FQHCLA458F
Grant Number
LALCS00170
Additional Details
Current Program Status
Active
Registration Date
1/9/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/5/2024
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
InterCommunity
Kim Beauregard, CEO
(860) 569-5900
Primary Contact
InterCommunity Health Care
Aneta Godlewski, VP
(860) 805-8428
Addresses
Street Address
15 Mercer Ave
East Hartford, CT 06118-1517
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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