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CH03160A TRI-STATE COMMUNITY HEALTH CENTER (Active)
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Main Details
Name
TRI-STATE COMMUNITY HEALTH CENTER
Subdivision Name
TRI-STATE COMMUNITY -CUMBERLAND
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004999
340B ID
CH03160A
Grant Number
H80CS00069
Additional Details
Current Program Status
Active
Registration Date
1/1/2004
Participating Start Date
1/1/2004
Participating Approval Date
4/22/2005
Last Recertification Date
3/10/2025
Contacts
Authorizing Official
Tri-State Community Health Center
SHEILA DESHONG, COO
(301) 678-5187 Ext: 226
Primary Contact
Tri-State Community Health Center
James Seaver, Director of Clinical Services
(301) 678-5187
Addresses
Street Address
621 Kelly Rd
Cumberland, MD 21502-2878
Billing Address
TRI-STATE COMMUNITY HEALTH CENTER, INC.
109 Rayloc Drive
HANCOCK, MD 21750
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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NEW SITE 01/01/2004, 4/22/05 - ADDED SHIP TO FOR PRE-PACKS ONLY AND BILL TO, 1/17/06 - NEW ADDR (WAS 1313 NATIONAL HIGHWAY, LAVALE, MD 21502)
01/17/2006
April 2025
April 2025
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