Covered Entity Details

CH01081A Southwest Community Health Center, Inc. (Terminated)

Main Details

Name

Southwest Community Health Center, Inc.

Subdivision Name

SOUTHWEST COMMUNITY HLTH CTR, INC

Type

HRSA-Funded Health Center

Site ID

BPS-H80-003410

340B ID

CH01081A

Grant Number

H80CS00613

Additional Details

Current Program Status

Terminated

Registration Date

4/5/2019

Participating Start Date

4/11/2019

Participating Approval Date

4/10/2019

Last Recertification Date

1/28/2020

Termination Date
Termination Reason

4/1/2020
Site closure

Contacts

Authorizing Official

South-West Community Health Center, Inc.
Mollie Melbourne, President/CEO
(203) 332-3501

Primary Contact

Southwest Community Health center,Inc
Naila Haroon, Manager 340 B Program & Credentialing
(203) 332-3564

Addresses

Street Address

743 South Ave
Bridgeport, CT 06604-5810

Billing Address

SOUTHWEST COMMUNITY HEALTH CENTER, INC.
46 Albion Street
BRIDGEPORT, CT 06605

Comment	Last Updated On
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1 Item 1 to 2 of 2 Page: of 1 Page size:
Participating from effective date (1/1/2004) until terminated effective date (4/1/2019), reinstatement effective date (04/11/2019).	04/11/2019
Participating from effective date (1/1/2004) until terminated effective date (4/1/2019), reinstatement effective date (07/01/2019)	04/10/2019

340B Drug Pricing Program Database