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CH07720A 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 - Tampa
Type
HRSA-Funded Health Center
Site ID
BPS-H80-008476
340B ID
CH07720A
Grant Number
H80CS00275
Additional Details
Current Program Status
Active
Registration Date
10/1/2003
Participating Start Date
10/1/2003
Participating Approval Date
9/25/2003
Last Recertification Date
2/13/2025
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
440 E Tampa St
Springfield, MO 65806-1131
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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8/5/09 BILL TO ADD - 7/22/09 ADDR & SUB DIV NAME CHANGE (WAS EASTSIDE CLINIC 3000 EAST DIVISION STREET)11/28/05 - ADDED MEDICAID #606226702
08/05/2009
April 2025
April 2025
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