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CH077200 ADVOCATES FOR A HEALTHY COMMUNITY INC (Active)
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Main Details
Name
ADVOCATES FOR A HEALTHY COMMUNITY INC
Subdivision Name
Jordan Valley Community Health Center - Benton
Type
HRSA-Funded Health Center
Site ID
BPS-H80-005335
340B ID
CH077200
Grant Number
H80CS00275
Additional Details
Current Program Status
Active
Registration Date
7/26/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/27/2017
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
Advocates for a Healthy Community, Inc.
Ryan Kruger, VP PACE/Pharmacy
(417) 851-1551
Primary Contact
Advocates for a Healthy Community, Inc.
Clifford James Conquest, Manager, 340B Program
(417) 851-1551
Addresses
Street Address
618 N Benton Ave
Springfield, MO 65806-1102
Billing Address
Advocates for a Healthy Community, Inc. dba Jordan Valley Community Health Center
PO Box 5681
Springfield, MO 65801-5681
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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7/27/17;Participating 10/1/2003 until terminated effective 4/1/2016, reinstated effective 10/1/2017.
07/27/2017
11/28/05 ADDED MEDICAID #606226702
01/14/2010
May 2025
May 2025
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