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CH062797E AMISTAD COMMUNITY HEALTH CENTER, INCORPORATED (Active)
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Main Details
Name
AMISTAD COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
Amistad Health Aransas Pass Suite 3
Type
HRSA-Funded Health Center
Site ID
BPS-H80-039212
340B ID
CH062797E
Grant Number
H80CS08778
Additional Details
Current Program Status
Active
Registration Date
10/24/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/28/2024
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Amistad Community Health Center
Eric Baggerman, CEO
(361) 960-9052
Primary Contact
Amistad Community Health Center Inc
Leo Trevino, Staff Accountant
(361) 886-3033
Addresses
Street Address
1711 W Wheeler Ave STE 3
Aransas Pass, TX 78336-4536
Billing Address
AMISTAD COMMUNITY HEALTH CENTER.
1533 S Brownlee Blvd
Corpus Christi, TX 78404
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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