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CH061068R INNIS COMMUNITY HEALTH CENTER INC (Active)
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Main Details
Name
INNIS COMMUNITY HEALTH CENTER INC
Subdivision Name
North Iberville School Based Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-037971
340B ID
CH061068R
Grant Number
H80CS00855
Additional Details
Current Program Status
Active
Registration Date
1/11/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/18/2024
Last Recertification Date
2/18/2025
Contacts
Authorizing Official
Innis Community Health Center, Inc.
cindy peavy, Executive Director
(225) 235-9627
Primary Contact
Innis Community Health Center, Inc.
Tracy Lyn Hooper, 340B Administrator
(225) 618-5015
Addresses
Street Address
13770 hwy 77
Rosedale, LA 70772
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
May 2025
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