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CH07119AF AFFINIA HEALTHCARE (Active)
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Main Details
Name
AFFINIA HEALTHCARE
Subdivision Name
Affinia Healthcare Ferguson
Type
HRSA-Funded Health Center
Site ID
BPS-H80-033817
340B ID
CH07119AF
Grant Number
H80CS00415
Additional Details
Current Program Status
Active
Registration Date
4/9/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/18/2024
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Affinia Healthcare
Leslie S O'Connor, CFO
(618) 343-5786
Primary Contact
Affinia Healthcare
Kendra Holmes, President CEO
(314) 779-7530
Addresses
Street Address
3396 Pershall Rd
Ferguson, MO 63135
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
June 2025
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