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CH07731A COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, INC (Terminated)
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Main Details
Name
COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, INC
Subdivision Name
CHC/SEIA KHS KEOKUK CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001438
340B ID
CH07731A
Grant Number
H80CS00272
Additional Details
Current Program Status
Terminated
Registration Date
1/1/2004
Participating Start Date
1/1/2004
Participating Approval Date
3/19/2004
Last Recertification Date
2/9/2024
Termination Date
Termination Reason
1/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Community Health Centers of Southeast Iowa
James Kammerer, Interim CEO
(319) 753-2300 Ext: 700197
Primary Contact
Community Health Centers of Southeastern Iowa
Ann Speers, Admin Support Services Manager
(319) 576-3779
Addresses
Street Address
400 N 17th St
Keokuk, IA 52632-3452
Billing Address
Community Health Centers of Southeastern Iowa, Inc.
1706 West Agency Rd
West Burlington, IA 52655
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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