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CH05102G HACKLEY COMMUNITY CARE CENTER INC (Active)
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Main Details
Name
HACKLEY COMMUNITY CARE CENTER INC
Subdivision Name
Hackley Community Care Center Mobile Dental Unit 1
Type
HRSA-Funded Health Center
Site ID
BPS-H80-029790
340B ID
CH05102G
Grant Number
H80CS00684
Additional Details
Current Program Status
Active
Registration Date
7/15/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/15/2024
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
Hackley Community Care Center
Valerie J Blondin, CFO
(231) 733-6657
Primary Contact
Hackley Community Care Center, Inc
Troy McLouth, Pharmacy Manager
(231) 733-6665
Addresses
Street Address
501 W Hovey
Muskegon Hts, MI 49444-2157
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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